내시경하 갑상선수술의 국내 현황

Abstract

Purpose: The endoscopic surgery has been widely used and developed in operations of the thyroid and parathyroid gland because of the cosmetic advantage and the development of laparoscopic instrument. Since the first endoscopic thyroid surgery in late 1990's, many endoscopic operations for thyroid tumors have been performed in Korea. The authors analyzed the current status of endoscopic thyroid surgery performed in Korea. Methods: We have collected and analyzed the data of endoscopic thyroid operations using survey. Results: The surgeons working in 16 hospitals answered the questions in survey. The total endoscopic thyroid operations were performed over 1,200 cases until the end of 2004. In the pathologic diagnosis, nodular hyperplasia was most frequent in 64.5%. The axillary approach was most frequently applied in 9 hospitals (56.2%). Most of endoscopic thyroid operations were performed in 2∼3 hours. The operation time was decreased according to the experience. The endoscopic surgery for malignant tumors were also performed in 11 hospitals, The hospital stay was usually 3∼4 days. The most common complications in endoscopic thyroid surgery were temporary recurrent laryngeal nerve paralysis and anteior chest wall discomfort or paresthesia. The most common reason for conversion to conventional surgery was the intraoperative diagnosis as for a malignancy. Conclusion: Endoscopic thyroid surgery has been perfomed in many hospitals not only special thyroid clinic in Korea. The operation cases are increasing rapidly in these days. According to the development of technique and instrument, the endoscopic surgery are applied to various neck disease involving malignancy. The safety and efficacy of endoscopic surgery for malignancy should be further evaluated with accumulation of experience of endoscopic operation and long term follow-up of thyroid cancer patients.