ABSTRACT
Objective:
To explore the experience and
learning curve of single-line
suspension suction rod-assisted
hybrid cavity-building
thyroid surgery via the oral vestibular approach.
Methods:
Clinical data of 138
patients undergoing single-line
suspension suction rod-assisted
hybrid cavity-building
thyroid surgery via oral vestibular approach from Sep. 2019 to Dec. 2021 in the Department of
Thyroid and
Breast Surgery of Affiliated
Hospital of North Sichuan Medical College were retrospectively analyzed. The cumulative sum (CUSUM)
method and best-fit curve
analysis were used to compare the differences in each index such as
operative time, intraoperative
bleeding, number of
lymph nodes cleared in the central region and postoperative related
complications at various stages of the
learning curve.
Results:
All 138
patients underwent single-line
suspension rod-assisted
hybrid cavity-building
thyroid surgery via the oral vestibular approach, and one
patient was converted to open
surgery due to large intraoperative
bleeding in the mass. There were 14
males and 124
females, mean age (36.07±8.49) years (20-55 years),
thyroid tumor size (7.74±6.49) mm (2.4-50mm), 5 cases underwent Subtotal
thyroidectomy, 129 cases underwent Unilateral lobectomy +
lymph node dissection in the middle region, and 4 cases total
thyroidectomy + central zone
lymph node dissection. The number of surgical cases corresponding to the apex of the CUSUM
learning curve was 45, and the
learning curve was divided into two stages the
learning improvement stage (1-45 cases) and the mastery stage (46-138 cases). The
operative time, intraoperative
bleeding, postoperative
hospital stay, and
chin numbness were all lower in the proficiency period than in the
learning and
training period ( P<0.05), and the number of
lymph nodes cleared in the central region was larger than that in the
learning and improvement stage ( P<0.05), while the differences in other indexes between the two stages were not statistically significant ( P>0.05) .
Conclusion:
The single-line
suspension suction rod-assisted
hybrid cavity-building
thyroid surgery via the oral vestibular approach has clinical application value and is worth promoting, and the number of surgical cases to be accumulated to master this
technique is 45.
