2021年9月14日
Learning curve for endoscopic thyroidectomy using video-assisted neck surgery: retrospective analysis of a single surgeon's experience of 100 cases.
Journal of Nippon Medical School = Nippon Ika Daigaku zasshi
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- 巻
- 89
- 号
- 3
- 開始ページ
- 277
- 終了ページ
- 286
- 記述言語
- 英語
- 掲載種別
- 研究論文(学術雑誌)
- DOI
- 10.1272/jnms.JNMS.2022_89-302
BACKGROUND: Endoscopic thyroidectomy offers excellent cosmetic outcomes, but requires a period of time for surgeons to become proficient. We examined the learning curve for the first 100 cases experienced by a single surgeon using a video-assisted neck surgery (VANS) subclavian approach. METHODS: We retrospectively studied 100 patients (99 women, 1 man; mean age, 36.2 years) with both benign and malignant thyroid diseases treated between 2016 and 2020. RESULTS: Preoperative diagnosis was papillary thyroid carcinoma (PTC) in 36 cases and other (non-PTC) in 64 cases. All patients underwent lobectomy, with unilateral central node dissection added for patients with PTC. Mean operative time was 125 min for non-PTC cases and 129 min for PTC cases (p = 0.43), with blood loss of 33.8 ml and 7.6 ml, respectively (p = 0.01). Recurrent laryngeal nerve paralysis (RNP) was observed in 12 patients (12%) and hemorrhage in 2 patients (2%). Comparing the first 30 cases with the last 70 cases, no significant differences in operative time or blood loss were evident, although tumor size of non-PTC cases was significantly greater among later cases (32.4 mm vs. 39.5 mm, p = 0.039). RNP was significantly decreased in later cases (26.7% vs. 5.7%, p = 0.003). Multivariate analysis revealed tumor size as a significant risk factor for increased blood loss, and increased experience correlated significantly with the decrease in RNP. CONCLUSIONS: In VANS, a certain surgical level was reached after experiencing 30 cases.
- リンク情報
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- DOI
- https://doi.org/10.1272/jnms.JNMS.2022_89-302
- PubMed
- https://www.ncbi.nlm.nih.gov/pubmed/34526468
- Scopus
- https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85133214101&origin=inward 本文へのリンクあり
- Scopus Citedby
- https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85133214101&origin=inward
- ID情報
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- DOI : 10.1272/jnms.JNMS.2022_89-302
- ISSN : 1345-4676
- eISSN : 1347-3409
- PubMed ID : 34526468
- SCOPUS ID : 85133214101