수술 전 위험도 분류에 따른 갑상선 유두암 치료 시 내시경 갑상선 절제술과 고식적 갑상선 절제술의 비교분석
A Comparative Analysis of Endoscopic Versus Conventional Open Thyroidectomy in the Treatment of Papillary Thyroid Cancer According to Preoperative Risk Stratification
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Purpose: It is well known that papillary thyroid cancer (PTC) has a good prognosis and high incidence in young women. The objective of the study was to review our criteria to select surgical modality and surgical results and to confirm the feasibility of endoscopic thyroidectomy according to the preoperative risk stratification in the treatment of papillary thyroid cancer. Methods: Between May 2009 and April 2012, 197 patients underwent either a conventional open or an endoscopic thyroidectomy with the preoperative consideration of risk group using clinical parameters of AMES system (patient age, size of tumor, extrathyroid extension, and presence of distant metastasis). A retrospective analysis of the pathologic data according to AMES system after surgery was also conducted. The endoscopic thyroidectomy was performed using the BABA (bilateral axillo-breast approach) method. Results: Based on the method of operation, the low-risk group patients (n=197) were divided into two groups: endoscopic group (n=78) and open group (n=119). Procedure time, postoperative complication rates, and length of hospital stay were tracked, albeit these were not significantly different between the two groups. From the pathologic findings, it was reported that there were no significant differences in tumor size, extrathyroid extension, and metastasis and also in the Off T4 – thyroglobulin level between the two groups. Conclusion: Endoscopic thyroidectomy is a feasible method for the treatment of selected cases of thyroid cancer such as low-risk group according to the appropriate preoperative risk stratification.
Abstract
Purpose: It is well known that papillary thyroid cancer (PTC) has a good prognosis and high incidence in young women. The objective of the study was to review our criteria to select surgical modality and surgical results and to confirm the feasibility of endoscopic thyroidectomy according to the preoperative risk stratification in the treatment of papillary thyroid cancer. Methods: Between May 2009 and April 2012, 197 patients underwent either a conventional open or an endoscopic thyroidectomy with the preoperative consideration of risk group using clinical parameters of AMES system (patient age, size of tumor, extrathyroid extension, and presence of distant metastasis). A retrospective analysis of the pathologic data according to AMES system after surgery was also conducted. The endoscopic thyroidectomy was performed using the BABA (bilateral axillo-breast approach) method. Results: Based on the method of operation, the low-risk group patients (n=197) were divided into two groups: endoscopic group (n=78) and open group (n=119). Procedure time, postoperative complication rates, and length of hospital stay were tracked, albeit these were not significantly different between the two groups. From the pathologic findings, it was reported that there were no significant differences in tumor size, extrathyroid extension, and metastasis and also in the Off T4 – thyroglobulin level between the two groups. Conclusion: Endoscopic thyroidectomy is a feasible method for the treatment of selected cases of thyroid cancer such as low-risk group according to the appropriate preoperative risk stratification.
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