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Objective:To investigate the effect of modified cervicothoracic compression band on successful hemostasis and postoperative complications of patients with endoscopic radical thyroidectomy via breast areola approach and to provide reference for postoperative nursing of thyroid cancer.Methods:A total of 128 patients with endoscopic radical thyroidectomy via breast areola approach from October 2018 to October 2019 in the Second Affiliated Hospital of Zhejiang University School of Medicine were selected and divided into experimental group(64 cases) and control group (64 cases) by random digits table method. Patients in the control group were fixed with wide adhesive tape for hemostasis, while patients in the experimental group wore modified cervicothoracic compression band. The postoperative complications between two groups were recorded, in addition, the physical condition and comfort of patients was assessed by Edmonton Symptom Assessment System (ESAS) and Kolcaba General Comfort Questionnaire (GCQ), respectively.Results:There was no sigrificance in the score of ESAS, GCQ on the 1st day before the operation between the two groups ( P>0.05). The median score of happiness in ESAS was 6.0 points in the experimental group on the 3rd day after the operation, significantly higher than 4.0 points in the control gorup, the difference was statistically significant ( Z value was 2.919, P<0.01). The physiological, psychological, social, cultural and environmental comfort, total GCQ scores were (10.73±2.35), (24.41±4.99), (23.09±2.11), (20.17±2.32), (78.41±6.49) points in the experimental group and (8.41±2.23), (22.42±4.79), (21.22±2.73), (19.20±2.97), (71.25±6.92) points in the control group, the differences were statistically significant ( t values were 2.058-6.031, P<0.05 or 0.01). The incidence of contact dermatitis, pressure purpura and tension blister were 0, 3.1% (2/64), 0 in the experimental group and 6.3% (4/64), 12.5% (8/64), 7.8% (5/64) in the control group, the differences were statistically significant ( χ2 values were 4.129, 3.095, 5.203, P<0.05). Conclusions:Modified cervicothoracic compression band can significantly alleviate the symptoms of postoperative patients with endoscopic radical thyroidectomy, reduce postoperative complications and improve patient comfort.
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Objective To compare the therapeutic effects between cervical and extra-cervical surgical approaches for endoscopic thyroidectomy . Methods From October 2012 to December 2013, forty-four thyroid goiter patients were divided into two groups randomly .Group A underwent modified Miccoli endoscopic thyroidectomy ( n =20 ) and group B underwent endoscopic thyroidectomy via breast areola approach ( n=24 ) .The operative time , intraoperative blood loss , pain in 24 hours postoperatively , drainage volume , postoperative hospital stay , hospital cost , complication and cosmetic results between the two groups were compared . Results Compared with group B, group A had shorter operative time [(77.9 ±28.3) min vs.(97.9 ±30.0) min, t=-2.259, P=0.029], less intraoperative blood loss [(15.9 ±8.7) ml vs.(29.5 ±16.1) ml, t=-3.384, P=0.002], less pain in 24 hours postoperatively ( no pain, endurable pain , intolerable pain in group A and B were 15, 5, 0 and 7, 15, 2 cases respectively , Z=-3.066, P=0.002), less postoperative drainage volume [(31.7 ±10.3) ml vs.(57.0 ±14.6) ml, t=-6.511, P=0.000], but poorer cosmetic results (very dissatisfied, not satisfied, satisfied, comparatively satisfied, and very satisfied in group A and B were 1, 4, 5, 6, 4 and 0, 1, 4, 5, 14 cases respectively, Z=-2.723, P=0.006).There was no significant difference in postoperative hospital stay and hospital cost between the two groups (P>0.05).One case suffered transient hoarseness in group A and one case had trembling hand due to low calcium level in group B and both of them recovered 1 month after symptomatic treatment .No permanent recurrent laryngeal nerve injury , parathyroid injury or other complications occurred in both groups . Conclusions Cervical approach is minimally invasive and leads to good cosmetic results while extra-cervical approach causes bigger trauma but leads to better cosmetic results.Patients with high cosmetic reguest may choose endoscopic thyroidectomy via breast areola approach .
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ObjectiveTo study the therapeutic effect and feasibility of endoscopic thyroidectomy via breast areola approach. MethodEndoscopic thyroidectomy via breast areola approach was performed in 62 patients, including 16 cases of adenoma, 43 cases of nodular goiter, and 3 cases of thyroid carcinoma.ResultsEndoscopic thyroidectomy was succeeded in 62 patients, 2 cases of cutaneous emphysema, 1 case of light skin bum which diameter was 0.5 cm, 1 case of transient hoarse voice,and 1 case of puncture sinus tract bleeding. There was no converted to open surgery,no hypercapnia, no damage of recurrent laryngeal nerve or parathyriod glands. ConclusionEndoscopic thyroidectomy via breast areola approach is safe and effective,and has good cosmetic results.
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Objective To investigate the curative effect of endoscopic thyroidectomy via breast areola approach.Methods The clinical data of 28 cases of endoscopic thyroidectomy via breast areola approach were retrospectively summarized.Results The mean diameter ofthe tumor Was 2.9(1.7～4.2)cm.The mean operative time Was 128(95～165) min.Pathologic data:adenoma in 15 cases,nodular goitar in 12 csses,papillary carcinoma indicated intraoperatively by frozen section in 1 case.One case occurred temporary hoarseness.No intraoperative and postoperative hemorrhea and convulsion after operation.Minor pain and discomfort in anterior chest continued for 7～19d in 18 cases,all without taking painkillers,satisfaction rate of beauty was 90 percent.Condusions Endoscopic thyroidectomy via breast areola approach is safe and feasible for patients with thyroid diseases,and has excellent cosmetic results.
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Objective To investigate the feasibility and cosmetic results of endoscopic thyroidectomy via breast areola approach.Methods From January 2004 to January 2006,endoscopic thyroidectomy was performed through the breast areola approach in 18 patients with benign thyroid mass.Results The surgery was accomplished successfully in all the 18 cases.The operation time ranged 45-120 min(mean,62 min) for unilateral resection and 90-180 min(mean,98 min) for bilateral resection.The intraoperative blood loss ranged 6-20 ml(mean,11 ml) for unilateral resection,and 15-70 ml(mean,29.5 ml) for bilateral resection.Postoperative hospital stay was 3-5 days.No complication occurred after the operation.The patients were followed up for 6-12 months(mean,9 months).The wound healed well in all the patients,inconspicuous scars or no recurrence was observed during the follow-up.Conclusions Endoscopic thyroidectomy via breast areola approach is a safe and feasible procedure with satisfying neck cosmetic outcome.
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Objective To explore the feasibility and advantages of endoscopic thyroidectomy via breast areola approach.Methods Endoscopic thyroidectomy via breast areola approach was performed in 113 cases between August 2002 and May 2005.Preoperative diagnosis included 46 cases of adenoma,62 cases of nodular goiter,and 5 cases of Graves' disease.Results The operation was successfully completed endoscopically in 112 cases,and was converted to conventional thyroidectomy in 1 case because of bleeding.The tumor was 2.3?1.6 cm in diameter(range,0.8~7.0 cm).The operating time was 136.7?58.0 min(range,50~310 min),the intraoperative blood loss was 42.5?62.7 ml(range,10~200 ml),the postoperative drainage volume was 87.1?78.1 ml(range,15~310 ml),the time to resume normal activities was 2.2?0.9 d(range,1~4 d),and the length of postoperative hospital stay was 5.5?1.9 d(range,2~9 d).Out of the 113 cases,analgesic requirement was necessary in 18 cases (15.9%).Postoperative complications occurred in 6 cases,including 2 cases of recurrent laryngeal nerve injuries,1 case of superior laryngeal nerve injuries,1 case of hemorrhage,1 case of hypocalcemia,and 1 case of recurrence of Graves' disease.Pathological results showed 43 cases of thyroid adenoma,58 cases of nodular goiter,5 cases of Graves' disease,3 cases of thyroid cancer,and 4 cases of Hashimoto's thyroiditis.Conclusions Endoscopic thyroidectomy via breast areola approach is a technically feasible and safe procedure.It can be employed as the first choice for indicated patients.