Endoscopic thyroidectomy via median approach with gas insufflation: analysis of the first 100 cases
Membres identifiés du Cancéropôle Est :
Dr GOUDET Pierre
Tous les auteurs :
Cougard P, Osmak-Tizon L, Balestra L, Dancea R, Goudet P
Objective: To report the initial experience with videoscopic thyroidectomy using a cervical approach with median placement of the optical trocar and gas insufflation. Patients and methods: Retrospective study of the first 100 consecutive patients. Results: Seven isthmectomies, 86 lobectornies, and 7 total thyroidectomies were performed. Parathyroidectomy for hyperparathyroidism was also performed in 3 patients. Mean operative time was 77 minutes. No post-operative subcutaneous emphysema was noted. Conversion to open surgery occurred in 10% of cases but the conversion rate decreased to 2.6% when the harmonic scalpel became available. Post-operative complications included one transient recurrent laryngeal nerve palsy. There were no hematomas and no hypocalcemia. The mean post-operative pain scale was 2.7 (on a visual scale of 1-10). Mean hospital stay was 1.5 days. The cosmetic result was considered excellent. Conclusions: Endoscopic total thyroidectomy aided by gas insufflation. is technically feasible. The harmonic scalpel aids greatly in dissection and hemostasis. It is a valid option in the surgical management of thyroid disease but careful pre-operative selection of patients is mandatory.
J Chir (Paris). 2007 Jul-Aug;144(4):297-300.