Araştırma Makalesi
Yıl 2018,
, 100 - 106, 01.06.2018
Öz
Aim: The
aim of this study was to determine whether minimally invasive parathyroid
surgery has any positive impact on cosmesis.
Materials and Methods: This case control study included 28 parathyroidectomized patients, who
had been operated between January 2006 – December 2008. All patients were
called back for at least 8 months after surgery. Demographics were recorded.
Minimally invasive parathyroidectomy versus conventional parathyroidectomy were
compared by means of skin features (using Fitzpatrick’s classification),
results of patient and independent observer scar assessment scales and
photographic scar analysis by the blinded plastic surgeon.
Results: There
were no differences in demographics and Fitzpatrick’s classification between
both groups. As expected, incision length of the minimal invasive group was
significantly shorter (2.6 ± 0.5cm vs. 4.9±1.0 cm, p=0.02). Meanwhile, no
significant difference in objective outcomes of patients between groups was
recorded. There was also no significant difference in photographic scar
analysis between groups, while independent observer scar assessment scale
scores were better in the minimal invasive group (p=0.03).
Conclusion: Although superior
results of an independent observer, assessment of cosmesis by the plastic
surgeon and the patient him/herself revealed no superiority of the minimally
invasive approach, when compared to conventional parathyroid surgery.
Anahtar Kelimeler
Kaynakça
- Gagner M. Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg 1996;83(6):875.
- Huscher CS, Chiodini S, Napolitano C, Recher A. Endoscopic right thyroid lobectomy. Surg Endosc 1997;11(8):877.
- Miccoli P, Berti P, Conte M, Bendinelli C, Marcocci C. Minimally invasive surgery for thyroid small nodules: preliminary report. J Endocrinol Invest. 1999;22(11):849-51.
- Ohgami M, Ishii S, Arisawa Y, et al. Scarless endoscopic thyroidectomy: breast approach for better cosmesis. Surg Laparosc Endosc Percutan Tech 2000;10(1):1-4.
- Ikeda Y, Takami H, Niimi M, Kan S, Sasaki Y, Takayama J. Endoscopic thyroidectomy by the axillary approach. Surg Endosc 2001;15(11):1362-4. Miccoli P, Berti P, Raffaelli M, Materazzi G, Baldacci S, Rossi G. Comparison between minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: A prospective randomized study. Surgery 2001;130(6):1039-43.
- Miccoli P, Bendinelli C, Berti P, Vignali E, Pinchera A, Marcocci C. Video-assisted versus conventional parathyroidectomy in primary hyperparathyroidism: a prospective randomized study. Surgery 1999;126(6):1117-22.
- Bellantone R, Lombardi CP, Bossola M, et al. Video-assisted vs conventional thyroid lobectomy: A randomized control trial. Arch Surg 2002;137(3):301-4.
- Ikeda Y, Takami H, Sasaki Y, Takayama J, Niimi M, Kan S. Clinical benefits in endoscopic thyroidectomy by the axillary approach. J Am Coll Surg 2003;196(2):189-95.
- Böhm B, Minner S, Engelhardt T, Rodiger H. Long term cosmetic results following thyroid resection. Chirurg 2005;76(1):54-7.
- Linos D, Economopoulos KP, Kiriakopoulos A, Linos E, Petralias A. Scar perceptions after thyroid and parathyroid surgery: Comparison of minimal and conventional approaches. Surgery 2013;153(3):400-7.
- O'Connell DA, Diamond C, Seikaly H, Harris JR. Objective and subjective scar aesthetics in minimal access vs conventional access parathyroidectomy and thyroidectomy surgical procedures: A paired cohort study. Arch Otolaryngol Head Neck Surg 2008;134(1):85-93. Toll EC, Loizou P, Davis CR, Porter GC, Pothier DD. Scars and satisfaction: do smaller scars improve patient-reported outcome? Eur Arch Otorhinolaryngol 2012;269(1):309-13.
- Tolley N, Garas G, Palazzo F, et al. Long-term prospective evaluation comparing robotic parathyroidectomy with minimally invasive open parathyroidectomy for primary hyperparathyroidism. Head Neck 2016 Apr; 38(Suppl 1):E300-6.
- Baum CL, Arpey CJ. Normal cutaneous wound healing: Clinical correlation with cellular and molecular events. Dermatol Surg 2005;31(6):674-86
- Wang LZ, Ding JP, Yang MY, Chen DW, Chen B. Treatment of facial post-burn hyperpigmentation using micro-plasma radiofrequency technology. Lasers Med Sci 2015;30(1):241-5.
- Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol 1988;124(6):869-71.
- Draaijers LJ, Tempelman FRH, Botman YAM, et al. The patient and observer scar assessment scale: A reliable and feasible tool for scar evaluation. Plast Reconstr Surg 2004;113(7):1960-5.
- Henry JF. Minimally invasive thyroid and parathyroid surgery is not a question of length of the incision. Langenbecks Arch Surg 2008;393(5):621-6.
- Sackett WR, Barraclough B, Reeve TS. Worldwide trends in the surgical treatment of primary hyperparathyroidism in the era of minimally invasive parathyroidectomy. Arch Surg 2002;137(9):1055-9.
- Henry JF, Thakur A. Minimal access surgery - thyroid and parathyroid. Indian J Surg Oncol 2010;1(2):200-6.
- O'Hara MW, Ghoneim MM, Hinrichs JV, Mehta MP, Wright EJ. Psychological consequences of surgery. Psychosom Med 1989;51(3):356-70
- Massetti M, Nataf P, Babatasi G, Khayat A. Cosmetic aspects in minimally invasive cardiac surgery. Eur J Cardiothorac Surg 1999;16(2):73-5.
- Dralle H, Machens A, Thanh PN. Minimally invasive compared with conventional thyroidectomy for nodular goitre. Best Pract Res Clin Endocrinol Metab 2014;28(4):589-99.
- Terris DJ, Seybt MW. Cosmesis in thyroid and parathyroid surgery: a matter of perspective. Arch Otolaryngol Head Neck Surg 2008;134(10):1120; author reply 1120-1
- Gracie D, Hussain SS. Use of minimally invasive parathyroidectomy techniques in sporadic primary hyperparathyroidism: systematic review. J Laryngol Otol 2012;126(3):221-7.
- Gal I, Solymosi T, Szabo Z, Balint A, Bolgar G. Minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: A prospective randomized study. Surg Endosc. 2008;22(11):2445-9.
- Radford PD, Ferguson MS, Magill JC, Karthikesalingham AP, Alusi G. Meta-analysis of minimally invasive video-assisted thyroidectomy. Laryngoscope 2011;121(8):1675-81
Yıl 2018,
, 100 - 106, 01.06.2018
Bulgular: İki grup arasında demografik veriler ve Fitzpatrick’s sınıflaması
açısından farklılık saptanmadı. Beklendiği gibi minimal invaziv grubun insizyon
uzunluğunun daha kısa olduğu belirendi (2.6 ± 0.5 cm’ye 4.9±1.0 cm; p=0.02).
Iki grup arasında objektif sonuçlar açısından anlamlı bir fark belirlenmedi.
Fotografik skar analizi açısından iki grup arasında anlamlı bir fark
belirlenmezken, bağımsız gözlemci skar değerlendirme skalası sonuçlarının
minimal invaziv cerrahi grubunda daha iyi olduğu belirlendi (p=0.03).
Öz
Amaç: Bu çalışmanın amacı
minimal invaziv paratiroidektominin kozmeziz üzerine olumlu bir etkisinin olup
olmadığının belirlenmesidir.
Gereç ve Yöntem: Bu olgu kontrol çalışması, Ocak 2006-Aralık 2008 tarihleri arasında
opera edilen 28 paratiroidektomili hastayı kapsamaktadır. Tüm hastalar
operasyondan en az 8 ay sonra kontrole çağırıldı. Demografik verileri
kaydedildi. Minimal invaziv paratiroidektomi ve konvansiyonel paratiroidektomi,
operasyon sonrası cilt özellikleri açısından (Fitzpatrick’s sınıflaması kullanılarak
belirlenen) bir plastik cerrah tarafından hasta sonuçları ve bağımsız gözlemci
skar değerlendirme skalası, fotografik skar analizi vasıtasıyla
karşılaştırıldı.
Bulgular: İki grup arasında demografik veriler ve Fitzpatrick’s sınıflaması
açısından farklılık saptanmadı. Beklendiği gibi minimal invaziv grubun insizyon
uzunluğunun daha kısa olduğu belirendi (2.6 ± 0.5 cm’ye 4.9±1.0 cm; p=0.02).
Iki grup arasında objektif sonuçlar açısından anlamlı bir fark belirlenmedi.
Fotografik skar analizi açısından iki grup arasında anlamlı bir fark
belirlenmezken, bağımsız gözlemci skar değerlendirme skalası sonuçlarının
minimal invaziv cerrahi grubunda daha iyi olduğu belirlendi (p=0.03).
Sonuç: Bağımsız bir gözlemci
tarafından daha iyi sonuçlar olduğu belirtilse de, kozmetik sonuçlar bir
plastik cerrah ve hasta tarafından değerlendirildiğinde minimal invaziv
cerrahinin konvansiyonel cerrahiye göre bir üstünlüğünün olmadığı belirlendi.
Anahtar Kelimeler
Kaynakça
- Gagner M. Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg 1996;83(6):875.
- Huscher CS, Chiodini S, Napolitano C, Recher A. Endoscopic right thyroid lobectomy. Surg Endosc 1997;11(8):877.
- Miccoli P, Berti P, Conte M, Bendinelli C, Marcocci C. Minimally invasive surgery for thyroid small nodules: preliminary report. J Endocrinol Invest. 1999;22(11):849-51.
- Ohgami M, Ishii S, Arisawa Y, et al. Scarless endoscopic thyroidectomy: breast approach for better cosmesis. Surg Laparosc Endosc Percutan Tech 2000;10(1):1-4.
- Ikeda Y, Takami H, Niimi M, Kan S, Sasaki Y, Takayama J. Endoscopic thyroidectomy by the axillary approach. Surg Endosc 2001;15(11):1362-4. Miccoli P, Berti P, Raffaelli M, Materazzi G, Baldacci S, Rossi G. Comparison between minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: A prospective randomized study. Surgery 2001;130(6):1039-43.
- Miccoli P, Bendinelli C, Berti P, Vignali E, Pinchera A, Marcocci C. Video-assisted versus conventional parathyroidectomy in primary hyperparathyroidism: a prospective randomized study. Surgery 1999;126(6):1117-22.
- Bellantone R, Lombardi CP, Bossola M, et al. Video-assisted vs conventional thyroid lobectomy: A randomized control trial. Arch Surg 2002;137(3):301-4.
- Ikeda Y, Takami H, Sasaki Y, Takayama J, Niimi M, Kan S. Clinical benefits in endoscopic thyroidectomy by the axillary approach. J Am Coll Surg 2003;196(2):189-95.
- Böhm B, Minner S, Engelhardt T, Rodiger H. Long term cosmetic results following thyroid resection. Chirurg 2005;76(1):54-7.
- Linos D, Economopoulos KP, Kiriakopoulos A, Linos E, Petralias A. Scar perceptions after thyroid and parathyroid surgery: Comparison of minimal and conventional approaches. Surgery 2013;153(3):400-7.
- O'Connell DA, Diamond C, Seikaly H, Harris JR. Objective and subjective scar aesthetics in minimal access vs conventional access parathyroidectomy and thyroidectomy surgical procedures: A paired cohort study. Arch Otolaryngol Head Neck Surg 2008;134(1):85-93. Toll EC, Loizou P, Davis CR, Porter GC, Pothier DD. Scars and satisfaction: do smaller scars improve patient-reported outcome? Eur Arch Otorhinolaryngol 2012;269(1):309-13.
- Tolley N, Garas G, Palazzo F, et al. Long-term prospective evaluation comparing robotic parathyroidectomy with minimally invasive open parathyroidectomy for primary hyperparathyroidism. Head Neck 2016 Apr; 38(Suppl 1):E300-6.
- Baum CL, Arpey CJ. Normal cutaneous wound healing: Clinical correlation with cellular and molecular events. Dermatol Surg 2005;31(6):674-86
- Wang LZ, Ding JP, Yang MY, Chen DW, Chen B. Treatment of facial post-burn hyperpigmentation using micro-plasma radiofrequency technology. Lasers Med Sci 2015;30(1):241-5.
- Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol 1988;124(6):869-71.
- Draaijers LJ, Tempelman FRH, Botman YAM, et al. The patient and observer scar assessment scale: A reliable and feasible tool for scar evaluation. Plast Reconstr Surg 2004;113(7):1960-5.
- Henry JF. Minimally invasive thyroid and parathyroid surgery is not a question of length of the incision. Langenbecks Arch Surg 2008;393(5):621-6.
- Sackett WR, Barraclough B, Reeve TS. Worldwide trends in the surgical treatment of primary hyperparathyroidism in the era of minimally invasive parathyroidectomy. Arch Surg 2002;137(9):1055-9.
- Henry JF, Thakur A. Minimal access surgery - thyroid and parathyroid. Indian J Surg Oncol 2010;1(2):200-6.
- O'Hara MW, Ghoneim MM, Hinrichs JV, Mehta MP, Wright EJ. Psychological consequences of surgery. Psychosom Med 1989;51(3):356-70
- Massetti M, Nataf P, Babatasi G, Khayat A. Cosmetic aspects in minimally invasive cardiac surgery. Eur J Cardiothorac Surg 1999;16(2):73-5.
- Dralle H, Machens A, Thanh PN. Minimally invasive compared with conventional thyroidectomy for nodular goitre. Best Pract Res Clin Endocrinol Metab 2014;28(4):589-99.
- Terris DJ, Seybt MW. Cosmesis in thyroid and parathyroid surgery: a matter of perspective. Arch Otolaryngol Head Neck Surg 2008;134(10):1120; author reply 1120-1
- Gracie D, Hussain SS. Use of minimally invasive parathyroidectomy techniques in sporadic primary hyperparathyroidism: systematic review. J Laryngol Otol 2012;126(3):221-7.
- Gal I, Solymosi T, Szabo Z, Balint A, Bolgar G. Minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: A prospective randomized study. Surg Endosc. 2008;22(11):2445-9.
- Radford PD, Ferguson MS, Magill JC, Karthikesalingham AP, Alusi G. Meta-analysis of minimally invasive video-assisted thyroidectomy. Laryngoscope 2011;121(8):1675-81
Toplam 26 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Haziran 2018 |
| Gönderilme Tarihi | 2 Şubat 2017 |
| Yayımlandığı Sayı | Yıl 2018 |