ﮔﺰارش اوﻟﯿﻦ ﺗﺠﺮﺑﻪ ﺟﺮاﺣﯽ ﺗﯿﺮوﺋﯿﺪ ﺑﻪ روش ﺗﺮاﻧﺲ آﮔﺰﯾﻼري آﻧﺪوﺳﮑﻮﭘﯿﮏ ﺑﺎ ﺗﻌﺒﯿﻪ ﺳﻪ ﺗﺮوﮐﺎر: ﮔﺰارش دو ﻣﻮرد ﺑﯿﻤﺎر

The First Experience of Three Ports Transaxillary Endoscopic Thyroidectomy: Report of 2 Cases

ﺟﺮاﺣﯽ ﺗﯿﺮوﺋﯿﺪ ﺑﻪ روش ﻣﺘﺪاول ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ اﯾﻤﻨﯽ و ﮐﺎراﯾﯽ آن، روﯾﮑﺮدي اﺳﺘﺎﻧﺪارد در ﺟﺮاﺣﯽ اﺳﺖ. اﻣﺎ ﻋﻮارض ﻧﺎﺷﯽ از ﺑﺮش ﻋﺮﺿﯽ ﮔﺮدن ﺑﺎﻋﺚ ﻧﺎرﺿﺎﯾﺘﯽ ﺑﯿﻤﺎران از ﻧﻈﺮ اﺳﮑﺎر ﻋﻤﻞ ﻣﯽﺷﻮد. ﺗﮑﻨﯿﮏﻫﺎي ﻣﺨﺘﻠﻒ ﺟﺮاﺣﯽ ﺗﯿﺮوﺋﯿﺪ ﺑﻪ روش آﻧﺪﺳﮑﻮﭘﯽ در ﻣﻘﺎﻻت ﮔﺰارش ﺷﺪه اﺳﺖ. ﮔﺰارش ﻣﻮﺟﻮد اوﻟﯿﻦ ﺗﺠﺮﺑﻪ ﺟﺮاﺣﯽ ﺗﯿﺮوﺋﯿﺪ در اﯾﺮان ﺑﻪ روش آﻧﺪوﺳﮑﻮﭘﯽ از ﻃﺮﯾﻖ ﺗﻌﺒﯿﻪ ﺳﻪ ﺗﺮوﮐﺎر ﻻﭘﺎروﺳﮑﻮﭘﯽ در ﻧﺎﺣﯿﻪ زﯾﺮﺑﻐﻞ ﺑﺎ ﻫﺪف ﺑﻪ ﺣﺪاﻗﻞ رﺳﺎﻧﺪن اﺳﮑﺎر در ﮔﺮدن ﻣﯽﺑﺎﺷﺪ. دو ﺑﯿﻤﺎر ﺑﺎ ﺗﺸﺨﯿﺺ ﻧﺪول ﺗﯿﺮوﯾﺪي ﺟﻬﺖ ﺟﺮاﺣﯽ در ﺑﯿﻤﺎرﺳﺘﺎن اﻣﺎم رﺿﺎ ﺗﺒﺮﯾﺰ ﺑﺴﺘﺮي ﺷﺪﻧﺪ. ﻫﻤﯽ ﺗﯿﺮوﺋﯿﺪﮐﺘﻮﻣﯽ آﻧﺪوﺳﮑﻮﭘﯿﮏ ﺑﺎ ﺗﻌﺒﯿﻪ ﯾﮏ ﺗﺮوﮐﺎر 10 ﻣﯿﻠﯿﻤﺘﺮي و دو ﺗﺮوﮐﺎر 5 ﻣﯿﻠﯿﻤﺘﺮي در ﻣﺤﺎذات ﺧﻂ آﮔﺰﯾﻼري ﻗﺪاﻣﯽ راﺳﺖ و ﺑﻪ ﮐﻤﮏ ﮔﺎز CO2 اﻧﺠﺎم ﺷﺪ. ﻋﻤﻞ ﺟﺮاﺣﯽ ﺑﺪون ﻫﯿﭽﮕﻮﻧﻪ ﻋﺎرﺿﻪاي ﺻﻮرت ﮔﺮﻓﺖ و ﺑﯿﻤﺎران روز ﺑﻌﺪ ﻋﻤﻞ ﻣﺮﺧﺺ ﺷﺪﻧﺪ. ﺟﺮاﺣﯽ ﺗﯿﺮوﺋﯿﺪ ﺑﻪ روش آﻧﺪوﺳﮑﻮﭘﯽ از ﻃﺮﯾﻖ ﺗﺮاﻧﺲ آﮔﺰﯾﻼ در ﺑﯿﻤﺎران اﻧﺘﺨﺎب ﺷﺪه روﺷﯽ اﯾﻤﻦ و ﻣﻨﺎﺳﺐ ﻣﯽﺗﻮاﻧﺪ ﺑﺎﺷﺪ.

Conventional surgery for open thyroidectomy is safe and effective. However, there have been concerns that neck Scarring can be a major source of dissatisfaction after surgery. To eliminate visible scarring on the neck, we successfully present the first attempt of transaxillary endoscopic thyroidectomy in Iran. Two patients were admitted with thyroid nodules in general thoracic surgery ward of Imam Reza hospital, Tabriz, Iran. Endoscopic hemithyroidectomy was performed via a unilateral axilla approach with CO2 insufflation. A 10-mm and two 5-mm trocars were inserted at the anterior axillary line. The patients successfully underwent endoscopic thyroidectomy and tolerated the procedure well without any complications. Endoscopic hemithyroidectomy via a unilateral axilla approach is safe and feasible in selective patients with thyroid disease. To our knowledge, the current study is the first clinical experience with novel technique for thyroid surgery in Iran.