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Chen ZX, Chen JB, Pang FS, Lin ZH, Zhang XB, Cai BY, Zheng WW, Cao Y, Qin Y. A novel hybrid approach for "Scarless" (at the neck) lateral neck dissection for papillary thyroid carcinoma: A case series and literature review. Front Oncol 2022; 12:985761. [PMID: 36568147 PMCID: PMC9780263 DOI: 10.3389/fonc.2022.985761] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/21/2022] [Indexed: 12/13/2022] Open
Abstract
Lateral neck dissection (LND) is a necessary treatment for thyroid cancer with lateral lymph node metastasis. However, the defect created during open surgery leaves a visible scar on the neck. With advancements in surgical technology, many robotic and endoscopic surgical techniques have been reported as alternatives to open surgery. In this study, we present a case series demonstrating the successful application of a novel hybrid approach for endoscopic LND and a review of different surgical approaches for "scarless" (at the neck) LND. We performed endoscopic LND via a combined chest and transoral approach in 24 patients between January 2021 and March 2022. The surgery was completed successfully in all patients with an average operation time of 298.1 ± 72.9 min. The numbers of positive/retrieved lymph nodes at levels II, III-IV, and VI were 0.7 ± 0.9/8.4 ± 4.1, 3.6 ± 2.7/19.5 ± 6.8, and 4.9 ± 3.9/10.3 ± 4.5, respectively. Complications included transient hypoparathyroidism in 10 patients, transient recurrent laryngeal nerve injury in 1 patient, internal jugular vein (IJN) injury in 1 patient, IJN sacrifice due to cancer invasion in 1 patient, and chyle leak in 1 patient, and no cases of tumor recurrence were observed during follow-up. The present case series indicates that the combined chest and transoral approach is feasible and effective for performing LND. Our review of different approaches for "scarless" (at the neck) LND identified advantages and disadvantages for all techniques. Our novel approach has unique advantages, and thus, it can provide an ideal surgical procedure for specific papillary thyroid carcinoma patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | - You Qin
- *Correspondence: You Qin, ; Zhen-Xin Chen,
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2018 CUA Abstracts. Can Urol Assoc J 2018; 12:S51-S136. [PMID: 29877793 PMCID: PMC5991937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Cruz JASD, Miranda AF, Costa LED, Azevedo RUD, Reis STD, Srougi M, Passerotti CC. Assessment of a new kind of surgical simulator. The physical surgical simulator. Acta Cir Bras 2018; 33:86-94. [PMID: 29412236 DOI: 10.1590/s0102-865020180010000009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 12/11/2017] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To evaluate whether the use of the physical surgical simulator may benefit the development of laparoscopic skills. METHODS Ten medical students were divided into two groups: the first one performed ten weekly training sessions with a physical surgical simulator - ETX A2 LAP and, afterwards, one laparoscopic cholecystectomy in a porcine model, while the second group performed only a laparoscopic cholecystectomy. Both groups were compared regarding bleeding, total surgical time, time to perform each surgical step and qualitative parameters, based on a previously validated tool. RESULTS There was no difference in any of the evaluated parameters. CONCLUSION We did not find any evidence of benefit in the use of the physical simulator for surgical performance in medical students.
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Affiliation(s)
- José Arnaldo Shiomi da Cruz
- MD, MSc, Laboratory of Medical Research, Urology - LIM 55, Medical School, Universidade de São Paulo (USP), Brazil. Conception, design and scientific content of the study; manuscript preparation; critical revision; final approval
| | - André Filipe Miranda
- MD, Laboratory of Medical Research, Urology - LIM 55, Medical School, USP, Sao Paulo-SP, Brazil. Technical procedures, interpretation of data, manuscript preparation
| | - Lucas Evangelista da Costa
- MD, Laboratory of Medical Research, Urology - LIM 55, Medical School, USP, Sao Paulo-SP, Brazil. Technical procedures, interpretation of data, manuscript preparation
| | - Rafael Ulysses de Azevedo
- MD, Laboratory of Medical Research, Urology - LIM 55, Medical School, USP, Sao Paulo-SP, Brazil. Technical procedures, interpretation of data, manuscript preparation
| | - Sabrina Thalita Dos Reis
- PhD, Associate Professor, Laboratory of Medical Research, Urology - LIM 55, Medical School, USP, Sao Paulo-SP, Brazil. Manuscript preparation, critical revision, final approval
| | - Miguel Srougi
- PhD, Full Professor, Laboratory of Medical Research, Urology - LIM 55, Medical School, USP, Sao Paulo-SP, Brazil. Manuscript preparation, critical revision, final approval
| | - Carlo Camargo Passerotti
- PhD, Associate Professor, Laboratory of Medical Research, Urology - LIM 55, Medical School, USP, Sao Paulo-SP, Brazil. Manuscript preparation, critical revision, final approval
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Steffens D, Thanigasalam R, Leslie S, Maneck B, Young JM, Solomon M. Robotic Surgery in Uro-oncology: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Urology 2017; 106:9-17. [PMID: 28336286 DOI: 10.1016/j.urology.2017.03.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 01/23/2017] [Accepted: 03/08/2017] [Indexed: 11/20/2022]
Abstract
Robotic surgery represents a new horizon in minimally invasive urologic surgery. This systematic review of the literature and meta-analysis examines the effectiveness of robotic surgery compared with laparoscopic or open surgery for major uro-oncological procedures. Twenty-five articles reported findings from 8 trials of prostatectomy (4 trials) and cystectomy (4 trials) including 1033 participants. Robotic surgery is comparable with laparoscopic or open surgery for oncological outcomes and overall complications, and provides somewhat better functional outcome when compared with laparoscopic and open surgery.
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Affiliation(s)
- Daniel Steffens
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital (RPAH), Sydney, Australia; Sydney Medical School, The University of Sydney, Sydney, Australia.
| | - Ruban Thanigasalam
- The Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, Australia
| | - Scott Leslie
- The Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, Australia
| | - Bharvi Maneck
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital (RPAH), Sydney, Australia
| | - Jane M Young
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital (RPAH), Sydney, Australia; Sydney Medical School, The University of Sydney, Sydney, Australia; The Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, Australia
| | - Michael Solomon
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital (RPAH), Sydney, Australia; Sydney Medical School, The University of Sydney, Sydney, Australia; The Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, Australia
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