1.Efficacy of endoscopic thyroidectomy in the treatment of thyroid cancer and its effects on patient's quality of life
Yulin LI ; Shuifeng SHAO ; Hanyin ZHAO ; Xiaojuan ZHENG
Chinese Journal of Primary Medicine and Pharmacy 2022;29(10):1506-1509
Objective:To investigate endoscopic thyroidectomy in the treatment of thyroid cancer and its effects on patient's quality of life.Methods:A total of 98 patients with thyroid cancer who received treatment in Zhoushan Hospital from March 2019 to March 2021 were included in this study. They were randomly divided into observation and control groups, with 49 patients in each group. Patients in the observation group underwent endoscopic thyroidectomy, and those in the control group underwent traditional surgery. Perioperative indicators and postoperative complications were compared between the two groups. Stress response measured before and 2 months after surgery and quality of life before and 3 months after surgery were compared between the two groups.Results:Operative time in the observation group was significantly longer than that in the control group [(89.82 ± 18.49)] minutes vs. (63.24 ± 17.28) minutes, t = 7.35, P < 0.05]. Intraoperative blood loss and postoperative drainage in the observation group were (10.32 ± 2.28) mL and (29.25 ± 3.17) mL, which were significantly lower than (15.42 ± 3.56) mL and (40.52 ± 4.95) mL in the control group ( t = 8.44, 13.42, both P < 0.05). There was no significant difference in length of hospital stay between the two groups ( P > 0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group [4.08% (2/49) vs. 18.37% (9/49), χ2 = 5.01, P < 0.05]. At 2 days after surgery, white blood cell count, fasting plasma glucose, C-reactive protein in the observation group were (5.62 ± 0.41) × 10 9/L, (4.77 ± 0.38) mmol/L, and (13.25 ± 2.79) mg/L, which were significantly lower than (8.71 ± 0.98) × 10 9/L, (5.75 ± 0.45) mmol/L, (20.84 ± 3.86) mg/L in the control group ( t = 20.36, 11.64, 11.26, all P < 0.05). At 3 months after surgery, Karnofsky performance scale score in the observation group was significantly higher than that in the control group [(87.64 ± 4.35) points vs. (81.29 ± 4.02) points, t = 7.58, P < 0.05). Conclusion:Endoscopic thyroidectomy is highly effective on thyroid cancer, has few postoperative complications, produces little effect on stress response, and can improve the quality of life of patients.
2.Clinical effectiveness of endoscopic surgery using a chest-breast approach for thyroid papillary cancer
Mengyan DING ; Xinhai GUO ; Hanyin ZHAO
Chinese Journal of Primary Medicine and Pharmacy 2024;31(6):841-845
Objective:To investigate the efficacy of endoscopic surgery using a chest-breast approach for thyroid papillary cancer and its effect on stress response and pain transmitters.Methods:A total of 100 patients with thyroid papillary cancer who received treatment at Zhoushan Hospital between January 2022 and January 2023 were retrospectively included in this study. These patients were divided into an endoscopic surgery group and a traditional surgery group according to the surgical method used, with 50 patients in each group. The endoscopic surgery group received endoscopic surgery, while the traditional surgery group underwent traditional open surgery. Surgical indicators, postoperative complications, thyroid function measured before surgery and 5 days after surgery, stress response, and pain transmitters were compared between the two groups.Results:The operative time in the endoscopic surgery group was longer than that in the traditional surgery group [(147.84 ± 27.95) minutes vs. (112.31 ± 23.16) minutes, t = 6.92, P < 0.001]. Intraoperative blood loss in the endoscopic surgery group was less than that in the traditional surgery group [(20.81 ± 4.24) mL vs. (37.74 ± 6.56) mL, t = 15.33, P < 0.001]. Postoperative drainage amount in the endoscopic surgery group was significantly less than that in the traditional surgery group [(32.34 ± 6.84) mL vs. (47.96 ± 12.31) mL, t = 7.84, P < 0.001]. Postoperative length of hospital stay in the endoscopic surgery group was significantly shorter than that in the traditional surgery group [(4.06 ± 1.31) days vs. (6.87 ± 1.54) days, t = 9.83, P < 0.001). The incidence of postoperative complications in the endoscopic surgery group was significantly lower than that in the traditional surgery group (6.00% vs 20.00%, χ2 = 4.33, P = 0.037). At 5 days post-surgery, the levels of triiodothyronine and thyroxine in the endoscopic surgery group were significantly lower than those in the traditional surgery group, while the level of thyroid stimulating hormone was significantly higher ( t = 5.57, 8.69, 10.17, all P < 0.001). At 5 days post-surgery, the levels of cortisol and malondialdehyde in the endoscopic surgery group were significantly lower than those in the traditional surgery group ( t = 9.31, 17.21, both P < 0.001). At 5 days post-surgery, the levels of substance P, neuropeptide Y, and prostaglandin E 2 in the endoscopic surgery group were significantly lower than those in the traditional surgery group ( t = 9.84, 13.65, 10.94, all P < 0.05). Conclusion:The endoscopic surgery using a chest-breast approach is highly effective in treating thyroid papillary cancer, with minimal complications. It greatly enhances thyroid function, elicits a low stress response, and effectively suppresses the release of pain transmitters.