Comparison of therapeutic effects between modified Miccoli surgery and total laparoscopic surgery via axillary approach in treatment of differentiated thyroid cancer
10.3969/j.issn.1009-9905.2024.11.008
- VernacularTitle:改良Miccoli术与经腋窝入路全腔镜手术治疗分化型甲状腺癌的疗效比较
- Author:
Chuan-wei SONG
1
;
Zhao-fang LIU
;
Zhao-lin LIU
Author Information
1. 菏泽市立医院 乳甲外科,山东 菏泽 274000
- Publication Type:Journal Article
- Keywords:
Thyroid cancer differentiation type;
Improved Miccoli technique;
Total laparoscopic surgery through axillary approach;
Curative effect
- From:
Chinese Journal of Current Advances in General Surgery
2024;27(11):877-881
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Explore and analyze the differences in therapeutic effects between modified Miccoli surgery and total laparoscopic surgery via axillary approach in the treatment of dif-ferentiated thyroid cancer. Methods:A total of 97 patients with differentiated thyroid cancer treated in Heze Municipal Hospital between December 2021 and December 2023 were selected as the subjects of this prospective study. A random number table method was used to divide 48 cases into an improved Miccoli surgery group and 49 cases into a total laparoscopic surgery group via axil-lary approach. The differences in surgical indicators,pain level (VAS score),inflammatory factors,aesthetic effect (VSS score),and incidence of complications between the two groups were com-pared. Results:The number of lymph node dissection between the two groups was similar,with no statistic difference (P>0.05). Compared to the group undergoing axillary total laparoscopic sur-gery,the modified Miccoli surgery group showed shorter surgical time,postoperative extubation time,neck recovery time,and hospital stay,as well as less intraoperative bleeding (P<0.05). Re-peated measures analysis of variance showed statistic difference (P<0.05) in VAS scores at time points,between groups,and interaction effects between the two groups. Over time,VAS scores in both groups decreased (P<0.05),and the modified Miccoli surgery group had lower VAS scores at 12 hours and 24 hours after surgery compared to the total laparoscopic surgery group via axillary approach (P<0.05). Compared with preoperative levels,both groups showed a decrease in vascular endothelial growth factor (VEGF) and an increase in tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) at 7 days postoperatively (P<0.05);and the degree of elevation and decrease in the modified Miccoli surgery group was better than that in the total laparoscopic surgery group via axillary approach (P<0.05). The thickness score,vascular distribution score,pigmentation score,flexibility score,and total VSS score of the modified Miccoli surgery group were higher than those of the total laparoscopic surgery group via axillary approach (P<0.05). There was no statistically sig-nificant difference in the incidence of complications between the two groups compared to the total incidence rate (P>0.05). Conclusion:Compared to total laparoscopic surgery via axillary ap-proach,the modified Miccoli procedure for treating differentiated thyroid cancer has less damage,faster postoperative recovery,and lower postoperative pain. However,its aesthetic effect is poor,and both methods are safe.
