Nonpneumatic unilateral axillary endoscopic or transoral vestibular endoscopic approach vs open thyroidectomy for papillary thyroid carcinoma
10.3760/cma.j.cn113855-20230906-00115
- VernacularTitle:经腋无充气腔镜、经口前庭无充气腔镜、颈部开放手术治疗甲状腺乳头状癌疗效的比较
- Author:
Deba SONG
1
;
Xiaojian ZHANG
;
Xiaoxu LI
;
Dan WANG
;
Hao ZHU
Author Information
1. 商丘市第一人民医院甲状腺乳腺外科，商丘 476100
- Publication Type:Journal Article
- Keywords:
Thyroid carcinoma ,papillary;
Thyroidectomy
- From:
Chinese Journal of General Surgery
2024;39(12):919-923
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the efficacy of gasless unilateral axillary endoscopic approach, transoral vestibular endoscopic approach and open thyroidectomy for papillary thyroid carcinoma (PTC).Methods:A retrospective analysis was made on 98 PTC patients who underwent surgical treatment at our hospital from Aug 2020 to Dec 2022,including 29 cases of transaxillary non pneumatic endoscopic surgery (group A), 33 cases of oral vestibular non pneumatic endoscopic surgery (group B), and 36 cases of traditional open neck surgery (group C). The operation related indicators, neck function, immune function, scar condition and postoperative complications of the three groups were compared.Results:The intraoperative blood loss (18.3±2.8),(30.2±4.2)ml in group A and group B was lower than that in group C (37.0±13.6)ml, the operation time (126.4±9.2) min,(191.0±60.1) min was longer than that in group C (73.8±6.3)min, and the drainage volume (91.8±5.4)ml,(85.2±6.1)ml was higher than that in group C (52.7±7.3)ml ( F=37.431, 94.144, 357.922, all P<0.05). The scores of dysphagia index (6.8±2.5,7.0±2.6) in group A and B were lower than those in group C (12.6±3.5) ( P<0.05). After treatment, surface antigen differentiation cluster 4 + (35.5±7.3,35.0±7.3,31.6±5.4), surface antigen differentiation cluster 4 +/surface antigen differentiation cluster 8 +level(1.4±0.4, 1.4±0.4, 1.0±0.3) decreased, and surface antigen differentiation cluster 8 +level (26.4±3.4 ,26.8 ±3.4, 29.5 ±3. 8) increased in the three groups,and the change amplitude in groups A and B was higher than that in group C ( P<0.05). At 3 months after operation, the VSS scores in group A and group B (6.0±1.0, 6.4±1.0) were lower than those in group C (8.5±1.2) ( F=18.925, P<0.05). Conclusions:Compared with open thyroidectomy for PTC, application of endoscopic thyroidectomy via gasless unilateral axillary or transoral vestibular approach has the advantage of a less swallowing impact and better patient satisfaction with cosmetic appearance, making it a safe and effective surgical procedure for clinical treatment of PTC.
