Clinical value of endoscopic thyroidectomy by gasless unilateral axillary approach in the treatment of elderly papillary thyroid carcinoma based on COX survival analysis
10.3760/cma.j.cn115807-20250408-00093
- VernacularTitle:基于COX生存分析探究经腋窝无充气腔镜手术治疗老年甲状腺乳头状癌的临床价值
- Author:
Houwei ZHU
1
;
Yulin ZHU
1
;
Wanzhong ZHAO
1
Author Information
1. 山东省烟台市烟台山医院甲状腺外科，烟台 264003
- Publication Type:Journal Article
- Keywords:
Survival analysis;
Papillary thyroid carcinoma;
Elderly;
Endoscopic thyroidectomy by gasless unilateral axillary approach
- From:
Chinese Journal of Endocrine Surgery
2025;19(5):720-724
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical value of endoscopic thyroidectomy by gasless unilateral axillary approach (ETGUA) on papillary thyroid carcinoma (PTC) in the elderly based on COX survival analysis.Methods:Clinical data of 51 elderly PTC patients who received traditional open surgery in Yantaishan Hospital, Yantai, Shandong Province from Mar. 2022 to Mar. 2025 were retrospectively analyzed and the patients included in control group. Clinical data of 54 elderly PTC patients who were treated with ETGUA during the same period were retrospectively analyzed and the patients were enrolled as observation group. The incidence rates of postoperative complications in the two groups were counted. The clinical related indexes (intraoperative blood loss, number of lymph node dissection, hospitalization time, surgical time) were compared. The survival rate was analyzed at 1 year, 2 years and 3 years after surgery, and the influencing factors of survival time of papillary thyroid carcinoma were analyzed by COX regression model.Results:The intraoperative blood loss in observation group was significantly less than that in control group ( t=12.56, P=0.000) while the number of lymph node dissection and surgical time were significantly more or longer than those in control group ( t=14.71, 13.90, P<0.05). There was no significant difference in hospitalization time between the two groups ( t=1.85, P=0.068). The total incidence rate of postoperative complications in observation group was significantly lower than that in control group ( χ 2= 8.57, P=0.000). Follow-up after 3 years revealed that the survival rate in observation group was significantly higher than that in control group ( χ 2= 4.95, P=0.026). COX survival analysis showed that age, TNM staging and tumor count were the influencing factors of survival time in PTC patients ( χ 2= 9.54, 7.30, 5.41, P=0.002, 0.007, 0.020) . Conclusion:ETGUA has good clinical value on elderly PTC patients, and it is helpful to reduce the degree of intraoperative trauma and the probability of postoperative complications, and improve the prognosis.
