A Single Surgeon’s 10-Year Experience in Remote-Access Thyroid and Parathyroid Surgery
| العنوان: | A Single Surgeon’s 10-Year Experience in Remote-Access Thyroid and Parathyroid Surgery |
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| المؤلفون: | Abdallah S. Attia, Hosam Shalaby, Sang W Kang, Ruhul Munshi, Mahmoud Shalaby, Emad Kandil, Mounika Akkera, Mohamed Saied Abdelgawad, Ahmed Elnahla, Lee Grace |
| المصدر: | The American Surgeon. 87:638-644 |
| بيانات النشر: | SAGE Publications, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Time Factors, Scars, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Robotic Surgical Procedures, medicine, Humans, 030223 otorhinolaryngology, Retrospective Studies, Parathyroidectomy, business.industry, General surgery, Thyroid, Endoscopy, General Medicine, Middle Aged, Single surgeon, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Thyroidectomy, Female, Parathyroid surgery, medicine.symptom, business, Learning Curve |
| الوصف: | Background Remote-access thyroid and parathyroid surgery has gained popularity recently due to its benefit of avoiding visible neck scars. Most of these techniques were described and performed in Asia, on patients with different body habitus compared to American patients. We aim to analyze the learning curve in performing these operations in North America. Methods This is a retrospective cohort study of a 10-year experience by a single surgeon at a North American institute. Patients who underwent thyroid or parathyroid procedures by a transaxillary, retroauricular, or transoral endoscopic thyroidectomy vestibular approach (TOETVA) were included. Cumulative sum (CUSUM) was used to analyze learning curves based on intraoperative blood loss and total operative times and learning phases were divided accordingly. Results Three hundred seventy-two remote-access thyroid and parathyroid procedures were performed during the study period. Total operative time for transaxillary procedures was initially reduced after the 69th procedure and then again after the 134th case. For retroauricular procedures, marked reduction in the operative time was observed after 21 procedures. Most patients (57.02%) were discharged home on the same day during the mastering phase. In the transaxillary procedures, only 1 case of brachial plexus injury occurred prior to the routine use of somatosensory evoked potential (SSEP) monitoring. Discussion Remote-access thyroid and parathyroid surgeries can be performed safely with minimal complications in a select group of patients. Analysis of the learning curve in performing these operations aids in structuring a safe and effective learning period for endocrine surgeons seeking to venture into this modality of treatment. |
| تدمد: | 1555-9823 0003-1348 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7f3447caeac144eb4c72787671967217 https://doi.org/10.1177/0003134820950300 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....7f3447caeac144eb4c72787671967217 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15559823 00031348 |
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