액와 단일절개 접근법을 이용한 내시경적 갑상선 절제술

Gasless Endoscopic Thyroidectomy Via Single Incision Axillary Approach

  • 김소영 (서울대학교 의과대학 분당서울대학교병원 이비인후과학교실) ;
  • 유윤종 (서울대학교 의과대학 분당서울대학교병원 이비인후과학교실) ;
  • 정우진 (서울대학교 의과대학 분당서울대학교병원 이비인후과학교실) ;
  • 안순현 (서울대학교 의과대학 분당서울대학교병원 이비인후과학교실)
  • Kim, So Young (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Ryu, Yoonjong (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Jeong, Woo-Jin (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Ahn, Soon-Hyun (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital)
  • 투고 : 2012.10.14
  • 심사 : 2012.10.30
  • 발행 : 2012.11.30

초록

Background and Objectives : To assure the surgical completeness of the gasless endoscopic thyroidectomy via single incision axillary approach using flexible videoscope which provide wide angle and working space, we compared single incision axillary approach and axillo-areolar approach by means of clinical, surgical outcomes. Materials and Methods : From March 2011 to July 2012, 24 patients who had underwent endoscopic thyroidectomy via transaxillary approach were enrolled. Of total, 17 patients underwent single incision axillary approach(group I) and the other 7 underwent axillo-areolar approach(group II). Results : Patient demographics, surgical indications were similar between the two groups. The operating time(group I 144.6min, group II 153.6 min ; p=.29), blood loss(group I : 55.4cc, group II : 35.7cc : p=.64), hospital stay(group I : 4.2days, group II : 4.4 days ; p=.65) were similar in the two groups. Overall, two patients in group I(2/17, 11.8%) experienced postoperative complications, including one hematoma and one seroma. Due to narrow working space, one patient was change to axillo-areolar approach during single incision axillary approach with $30^{\circ}$ rigid endoscope. Conclusion:Single incision axillary approach is safe and effective similar to other endoscopic thyroidectomy methods using flexible videoscope. Different with $30^{\circ}$ rigid endoscope, 10-mm flexible videoscope can put inside the axillary inicision site in different axis with endoscopic instruments. This difference in endoscopic axis help to prevent crash with endoscopic instrument.

키워드

참고문헌

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