RESUMEN
BACKGROUND: No studies have compared robot-assisted transaxillary thyroidectomy (RATT) and minimally invasive video-assisted thyroidectomy (MIVAT) regarding cosmetic outcome and satisfaction METHODS: Patients matching the inclusion criteria (benign nodule less than 4 cm and thyroid volume less than 30 mL) were randomly allotted to undergo MIVAT (group A) or RATT (group B). Cosmetic result, overall satisfaction, operative time, and complications were evaluated. RESULTS: A total of 62 patients underwent hemithyroidectomy (30 in group A and 32 in group B). All patients were women, with the exception of one man in each group. The mean patient age was 36.9 years (group A) and 32.5 years (group B). Total operative time (intubation-extubation) was shorter in group A (71.6 min) than in group B (120.4 min). Complications included one transient laryngeal nerve injury in each group and one subcutaneous hematoma in group B. Postoperative hospital stay was longer in group B (1.85 days) than in group A (1.15 days). On the PASQ questionnaire, "scar appearance" and "satisfaction with appearance" scores were better in group A than in group B. In the Short Form (SF-36) 36-Item Health Survey Questionnaire, domains of "social activity" and "general health" were better in group B than in group A, whereas "bodily pain" scored higher in group B than in group A. CONCLUSIONS: RATT seems not to supersede MIVAT in terms of satisfaction when comparing two groups of patients undergoing thyroidectomy for benign disease.
Asunto(s)
Estética , Satisfacción del Paciente/estadística & datos numéricos , Robótica/métodos , Tiroidectomía/métodos , Cirugía Asistida por Video/métodos , Adolescente , Adulto , Anciano , Axila/cirugía , Cicatriz/prevención & control , Método Doble Ciego , Endoscopía/métodos , Femenino , Humanos , Italia , Laringoscopía/métodos , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Cuidados Preoperatorios/métodos , Estudios Prospectivos , Estadísticas no Paramétricas , Tiroidectomía/instrumentación , Resultado del Tratamiento , Adulto JovenRESUMEN
Plexiform neurofibromas are benign tumors of the peripheral nerve. Diagnosis may be challenging, if they present mimicking other peripheral nerve pathologies. We report the case of a patient who had severe foot pain, which progressively hampered her walking ability, erroneously attributed to recurrent Morton's neuroma. Diagnosis of plexiform neurofibroma of her right medial plantar nerve was made 15 years after the appearance of symptoms. Pain and function recovered after radical neurotomy of the medial plantar nerve. A correct diagnosis is an essential starting point in the treatment of neurofibromas and a misdiagnosis may lead to an inappropriate treatment.