Key points of surgical anatomy for endoscopic thyroidectomy via a gasless unilateral axillary approach.

Autor: Meng K; Otolaryngology & Head and Neck Center, Cancer Center, Department of Head and Neck Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014, Zhejiang, China.; Zhejiang Key Laboratory of Precision Medicine Research On Head & Neck Cancer, Hangzhou, 310014, China.; Zhejiang Provincial Clinical Research Center for Malignant Tumor, Hangzhou, 310014, Zhejiang, China., Xin Y; Otolaryngology & Head and Neck Center, Cancer Center, Department of Head and Neck Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014, Zhejiang, China.; Zhejiang Key Laboratory of Precision Medicine Research On Head & Neck Cancer, Hangzhou, 310014, China.; Zhejiang Provincial Clinical Research Center for Malignant Tumor, Hangzhou, 310014, Zhejiang, China., Tan Z; Otolaryngology & Head and Neck Center, Cancer Center, Department of Head and Neck Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014, Zhejiang, China.; Zhejiang Key Laboratory of Precision Medicine Research On Head & Neck Cancer, Hangzhou, 310014, China.; Zhejiang Provincial Clinical Research Center for Malignant Tumor, Hangzhou, 310014, Zhejiang, China., Xu J; Otolaryngology & Head and Neck Center, Cancer Center, Department of Head and Neck Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014, Zhejiang, China.; Zhejiang Key Laboratory of Precision Medicine Research On Head & Neck Cancer, Hangzhou, 310014, China.; Zhejiang Provincial Clinical Research Center for Malignant Tumor, Hangzhou, 310014, Zhejiang, China., Chen X; Department of Thyroid, Breast & Hernia Surgery, Tiantai People's Hospital of Zhejiang Province, Tiantai Branch of Zhejiang Provincial People's Hospital, Hangzhou Medical College, Taizhou, 317200, Zhejiang, China., Gu J; Department of Thyroid and Breast Surgery, Zhejiang Southeast Campus of Zhejiang Provincial People's Hospital, Xianju People's Hospital, Affiliated Xianju's Hospital, Hangzhou Medical College, Xianju, 317300, Zhejiang, China., Jagadishbhai PN; Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China., Zheng C; Otolaryngology & Head and Neck Center, Cancer Center, Department of Head and Neck Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014, Zhejiang, China. mingdoc@163.com.; Zhejiang Key Laboratory of Precision Medicine Research On Head & Neck Cancer, Hangzhou, 310014, China. mingdoc@163.com.; Zhejiang Provincial Clinical Research Center for Malignant Tumor, Hangzhou, 310014, Zhejiang, China. mingdoc@163.com.
Jazyk: angličtina
Zdroj: Langenbeck's archives of surgery [Langenbecks Arch Surg] 2024 Oct 01; Vol. 409 (1), pp. 294. Date of Electronic Publication: 2024 Oct 01.
DOI: 10.1007/s00423-024-03473-y
Abstrakt: Purpose: Endoscopic thyroidectomy utilizing the Gasless Unilateral Axillary Approach (GUA) offers distinct advantages including clear visibility, simple manipulation, safe oncological outcomes. This technique eliminates postoperative neck scarring, ensures concealed surgical incisions, and minimizes postoperative swallowing discomfort.
Methods: We retrospectively reviewed 150 surgical videos to document key anatomical features and their variations during this procedure.
Results: The GUA endoscopic thyroidectomy, which approaches from the contralateral side, presents significant difficulties in identifying anatomical structures, especially anatomical abnormalities in the contralateral neck, while constructing feasible operative fields. This article offers an in-depth discussion of the anatomical challenges, pitfalls, and viable strategies associated with this surgery, particularly for less experienced surgeons.
Conclusions: Given the intricate interplay of muscular, vascular, and neural anatomical structures, novices in surgery must be well-acquainted with the underlying anatomy to minimize potential complications.
(© 2024. The Author(s).)
Databáze: MEDLINE
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