Zusammenfassung
GRUNDLAGEN: Die Entfernung der gesamten Schilddrüse ist in der Therapie bei gutartigen und bösartigen Erkrankungen der Schilddrüse etabliert, ist aber potentiell mit erhöhten postoperativen Komplikationen assoziiert. Es geht vor allem um die Schonung der Nervus laryngeus recurrens und der Nebenschilddrüsen. Die Autoren überlegten, ob die Lupenvergrößerung dazu beitragen kann, die angeführten Komplikationen zu vermeiden. METHODIK: Die totale Thyreoidektomie wurde mit (Gruppe A) und ohne (Gruppe B) Lupenvergrößerung durchgeführt. Stimmbandfunktion und Kalziumspiegel wurden postoperativ untersucht. ERGEBNISSE: Die Lupenvergrößerung verbessert die Identifizierung und Schonung des Nervus laryngeus recurrens und der Nebenschilddrüsen. SCHLUSSFOLGERUNGEN: Lupenvergrößerung bei Entfernung der gesamten Schilddrüse ist machbar, verbessert das Ergebnis und sollte von erfahrenen Chirurgen durchgeführt werden.
Summary
BACKGROUND: Total thyroidectomy has been accepted as current surgical therapy for benign and malignant thyroidal disorders but extensive resection might increase the risk of postoperative complications. Intensive effort should be spent to prevent recurrent laryngeal nerve injury and hypoparathyroidism, because they can be avoided with appropriate surgical technique during total thyroidectomy. The authors proposed that the use of a loupe for operative field magnification could improve the outcome of total thyroidectomy as regard to identification of both the recurrent laryngeal nerves and the parathyroids. METHODS: Patients were subjected to total thyroidectomy with loupe magnification in group A and without loupe in group B. The status of vocal cords of all patients was checked postoperatively by laryngoscope. Serum calcium concentration immediately postoperatively and during follow-up was checked. RESULTS: Loupe magnification helps identification of external branch of superior laryngeal nerve and parathyroid preservation. CONCLUSIONS: Total thyroidectomy by loupe magnification is feasible, improves the outcome, and should be done by experienced surgeon.
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Saber, A., Rifaat, M., Ellabban, G. et al. Total thyroidectomy by loupe magnification: a comparative study. Eur Surg 43, 49–54 (2011). https://doi.org/10.1007/s10353-011-0591-0
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DOI: https://doi.org/10.1007/s10353-011-0591-0