Objective To explore the experience and learning curve of single-line suspension suction rod-assisted hybrid cavity-building thyroid surgery via the oral vestibular approach.Methods Clinical data of 138 pa-tients undergoing single-line suspension suction rod-assisted hybrid cavity-building thyroid surgery via oral vestibu-lar approach from Sep.2019 to Dec.2021 in the Department of Thyroid and Breast Surgery of Affiliated Hospital of North Sichuan Medical College were retrospectively analyzed.The cumulative sum(CUSUM)method and best-fit curve analysis were used to compare the differences in each index such as operative time,intraoperative bleeding,number of lymph nodes cleared in the central region and postoperative related complications at various stages of the learning curve.Results All 138 patients underwent single-line suspension rod-assisted hybrid cavity-building thyroid surgery via the oral vestibular approach,and one patient was converted to open surgery due to large intraop-erative bleeding in the mass.There were 14 males and 124 females,mean age(36.07±8.49)years(20-55 years),thyroid tumor size(7.74±6.49)mm(2.4-50mm),5 cases underwent Subtotal thyroidectomy,129 cases underwent Unilateral lobectomy+lymph node dissection in the middle region,and 4 cases total thyroidectomy+central zone lymph node dissection.The number of surgical cases corresponding to the apex of the CUSUM learning curve was 45,and the learning curve was divided into two stages:the learning improvement stage(1-45 cases)and the mas-tery stage(46-138 cases).The operative time,intraoperative bleeding,postoperative hospital stay,and chin numb-ness were all lower in the proficiency period than in the learning and training period(P＜0.05),and the number of lymph nodes cleared in the central region was larger than that in the learning and improvement stage(P＜0.05),while the differences in other indexes between the two stages were not statistically significant(P＞0.05).Conclu-sion The single-line suspension suction rod-assisted hybrid cavity-building thyroid surgery via the oral vestibular approach has clinical application value and is worth promoting,and the number of surgical cases to be accumulated to master this technique is 45.
关键词
甲状腺癌/经口腔前庭入路腔镜甲状腺手术/混合建腔
Key words
Thyroid carcinoma/Transoral endoscopic thyroidectomy vestibular approach/Hybrid cavi-ty construction
维普
万方数据