본문 바로가기
KERD
논문KCI 등재

갑상선 유두암에서 BABA 내시경 갑상선 절제술에 대한 임상적 고찰

Endoscopic Thyroidectomy via Bilateral AxilloBreast Approach in Papillary Thyroid Carcinoma

1

조회

0

다운로드

1

인용

0

참고문헌

키워드

초록

Purpose: The aim of this study was to evaluate the operative feasibility and safety of endoscopic thyroidectomy via bilateral axillo breast approach (BABA) compared to conventional thyroidectomy in papillary thyroid carcinoma (PTC) patients. Methods: From July 2009 to November 2010, patients underwent BABA endoscopic thyroidectomy (ET group; n=41) or conventional open thyroidectomy (OT group; n=61) for PTC. Clinical and pathologic characteristics of patients, operation time, post-operative complications, cosmetic satisfaction and thyroglobulin (TG) level were analyzed retrospectively. 책임저자 : 박경식, 서울시 광진구 화양동 4-12󰂕143-729, 건국대학교병원 외과Tel: 02-2030-7697, Fax: 02-2030-7749E-mail: kspark@kuh.ac.kr 접수일:2011년 7월 21일, 수정일:2011년 9월 4일,게재승인일:2011년 9월 6일Results: The mean age of the patients was 40.05±9.58 years (range 25∼61 years) and 46.21±13.68 years (range 19∼79 years) for the ET and OT group, respectively. The operative extent in the ET group did not include advanced thyroid cancer or lateral neck dissection. The size of the tumor was 0.78±0.59 cm (range 0.1∼3.00 cm) and 1.54 ±1.05 cm (range 0.3∼6.00 cm) for the ET and OT group, respectively. Extrathyroidal extension and number of retrieved lymph nodes were significantly higher in the OT group. Postoperative radioactive iodine ablation was performed on 25 patients (72.43%) in the ET group and 48 patients (78.69%) in the OT group. There was no abnormal uptake on radioactive iodine scans in the iodine-treated patients and no significant differences in postoperative off-T4 TG levels between the two groups. There were no significant differences in operative time, amount of drainage, postoperative hospitalization period, hypocalcemia, and vocal cord palsy between the two groups. Cosmetic results of ET group were rated as excellent in a 3-month postoperative questionnaire by 25 (72.43%) of 35 patients. Conclusion: Endoscopic thyroidectomy via the bilateral axillo breast approach can be a feasible and effective option for PTC in selected cases. (Korean J Endocrine Surg 2011;11:158-163)

Abstract

Purpose: The aim of this study was to evaluate the operative feasibility and safety of endoscopic thyroidectomy via bilateral axillo breast approach (BABA) compared to conventional thyroidectomy in papillary thyroid carcinoma (PTC) patients. Methods: From July 2009 to November 2010, patients underwent BABA endoscopic thyroidectomy (ET group; n=41) or conventional open thyroidectomy (OT group; n=61) for PTC. Clinical and pathologic characteristics of patients, operation time, post-operative complications, cosmetic satisfaction and thyroglobulin (TG) level were analyzed retrospectively. 책임저자 : 박경식, 서울시 광진구 화양동 4-12󰂕143-729, 건국대학교병원 외과Tel: 02-2030-7697, Fax: 02-2030-7749E-mail: kspark@kuh.ac.kr 접수일:2011년 7월 21일, 수정일:2011년 9월 4일,게재승인일:2011년 9월 6일Results: The mean age of the patients was 40.05±9.58 years (range 25∼61 years) and 46.21±13.68 years (range 19∼79 years) for the ET and OT group, respectively. The operative extent in the ET group did not include advanced thyroid cancer or lateral neck dissection. The size of the tumor was 0.78±0.59 cm (range 0.1∼3.00 cm) and 1.54 ±1.05 cm (range 0.3∼6.00 cm) for the ET and OT group, respectively. Extrathyroidal extension and number of retrieved lymph nodes were significantly higher in the OT group. Postoperative radioactive iodine ablation was performed on 25 patients (72.43%) in the ET group and 48 patients (78.69%) in the OT group. There was no abnormal uptake on radioactive iodine scans in the iodine-treated patients and no significant differences in postoperative off-T4 TG levels between the two groups. There were no significant differences in operative time, amount of drainage, postoperative hospitalization period, hypocalcemia, and vocal cord palsy between the two groups. Cosmetic results of ET group were rated as excellent in a 3-month postoperative questionnaire by 25 (72.43%) of 35 patients. Conclusion: Endoscopic thyroidectomy via the bilateral axillo breast approach can be a feasible and effective option for PTC in selected cases. (Korean J Endocrine Surg 2011;11:158-163)

참고문헌 (26)

  1. 원영주, "Nationwide Cancer Incidence in Korea, 2003~2005", Cancer Research and Treatment, 41(3), pp.122~131 (2009), 대한암학회
  2. 정규원, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2008", Cancer Research and Treatment, 43(1), pp.1~11 (2011), 대한암학회
  3. 정기욱, "Endoscopic thyroidectomy for thyroid malignancies: Comparison with conventional open thyroidectomy", WORLD JOURNAL OF SURGERY, 31, pp.2302~2308, springer link
  4. Gagner M, "Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism", Br J Surg, 83, pp.875~ (1996)
  5. Hüscher CS, "Endoscopic right thyroid lobectomy", Surg Endosc, 11, pp.877~ (1997)
  6. Shimizu K, "Video-assisted neck surgery: endoscopic resection of thyroid tumors with a very minimal neck wound", J Am Coll Surg, 188, pp.697~703 (1999)
  7. Ikeda Y, "Endoscopic resection of thyroid tumors by the axillary approach", J Cardiovasc Surg (Torino), 41, pp.791~792 (2000)
  8. Ohgami M, "Scarless endoscopic thyroidectomy: breast approach for better cosmesis", Surg Laparosc Endosc Percutan Tech, 10, pp.1~4 (2000)
  9. Berti P, "Video-assisted thyroidectomy for Graves' disease: report of a preliminary experience", Surg Endosc, 18, pp.1208~1210 (2004)
  10. Miccoli P, "Minimally invasive video-assisted surgery of the thyroid: a preliminary report", Langenbecks Arch Surg, 385, pp.261~264 (2000)
  11. Miccoli P, "Minimally invasive video-assisted thyroidectomy for papillary carcinoma: a prospective study of its completeness", Surgery, 132, pp.1070~1073 (2002)
  12. Bellantone R, "Central neck lymph node removal during minimally invasive video-assisted thyroidectomy for thyroid carcinoma: a feasible and safe procedure", J Laparoendosc Adv Surg Tech A, 12, pp.181~185 (2002)
  13. Miccoli P, "Surgical treatment of low- and intermediate-risk papillary thyroid cancer with minimally invasive video-assisted thyroidectomy", J Clin Endocrinol Metab, 94, pp.1618~1622 (2009)
  14. Miccoli P, "Minimally invasive thyroidectomy in the treatment of well differentiated thyroid cancers: indications and limits", Curr Opin Otolaryngol Head Neck Surg, 18, pp.114~118 (2010)
  15. Chao TC, "Gasless video-assisted total thyroidectomy in the treatment of low risk intrathyroid papillary carcinoma", World J Surg, 28, pp.876~879 (2004)
  16. Jemal A, "Cancer statistics, 2007", CA Cancer J Clin, 57, pp.43~66 (2007)
  17. Juckett G, "Management of keloids and hypertrophic scars", Am Fam Physician, 80, pp.253~260 (2009)
  18. 정웅윤, "Gasless endoscopic thyroidectomy via an axillary approach: Experience of 30 cases", SURGICAL LAPAROSCOPY ENDOSCOPY & PERCUTANEOUS TECHNIQUES, 16, pp.226~231
  19. 정기욱, "Endoscopic thyroidectomy using a new bilateral axillo-breast approach", World Journal of Surgery, 31(3), pp.601~606, Springer Verlag
  20. Cooper DS, "American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, Revised American thyroid association management guidelines for patients with thyroid nodules and differentiated thyroid cancer", Thyroid, 19, pp.1167~1214 (2009)
  21. Cady B, "Papillary carcinoma of the thyroid gland: treatment based on risk group definition", Surg Oncol Clin N Am, 7, pp.633~644 (1998)
  22. Gemsenjäger E, "Lymph node surgery in papillary thyroid carcinoma", J Am Coll Surg, 197, pp.182~190 (2003)
  23. Ito Y, "Preoperative ultrasonographic examination for lymph node metastasis: usefulness when designing lymph node dissection for papillary microcarcinoma of the thyroid", World J Surg, 28, pp.498~501 (2004)
  24. Henry JF, "Morbidity of prophylactic lymph node dissection in the central neck area in patients with papillary thyroid carcinoma", Langenbecks Arch Surg, 383, pp.167~169 (1998)
  25. Cheah WK, "Complications of neck dissection for thyroid cancer", World J Surg, 26, pp.1013~1016 (2002)
  26. Randolph GW, "The surgical management of goiter: Part II. Surgical treatment and results", Laryngoscope, 121, pp.68~76 (2011)

관련 논문AI추천

양측 액와 유방 접근 내시경 갑상선 절제술에 대한 5년간의 분석박민호, 박윤철, 유영재, 윤정한, 조진성대한내분비외과학회 · Journal of Endocrine Surgery2015 · 제15권 제2호수술 전 위험도 분류에 따른 갑상선 유두암 치료 시 내시경 갑상선 절제술과 고식적 갑상선 절제술의 비교분석강병준, 김근영, 박경식, 서수연, 양정현, 유영범, 조민정대한내분비외과학회 · Journal of Endocrine Surgery2013 · 제13권 제2호유두갑상선암의 고식적 갑상선전절제술과 내시경하 갑상선전절제술 후 부갑상선 보존율 비교분석곽금희, 김기환, 김정빈, 박인석, 배병노, 양근호, 조현진, 한세환대한내분비외과학회 · Journal of Endocrine Surgery2012 · 제12권 제2호Endoscopic Thyroidectomy Via the Cervico-axillary Approach for Thyroid Cancer: Initial Experience in a Single Institute권형주, 김현구, 문병인, 백남선, 백세현, 안정신, 우주현, 이준우, 임우성대한내분비외과학회 · Journal of Endocrine Surgery2017 · 제17권 제1호미적 요인에 대한 환자 만족도를 중심으로 한 내시경적 갑상선 절제술 및 기존 술식의 비교 분석문병인, 이안복, 임우성, 장지나대한내분비외과학회 · Journal of Endocrine Surgery2010 · 제10권 제3호액와부 내시경 갑상선 절제술 후 나타날 수 있는 합병증에 대한 고찰김성흔, 이상민, 정갑중대한내분비외과학회 · Journal of Endocrine Surgery2010 · 제10권 제3호

이 간행물의 다른 논문 (8건)