Clinical effect of extended lumpectomy in the treatment of patients with single benign thyroid disease / 中国基层医药

ABSTRACT

Objective:To investigate the clinical effect of extended lumpectomy in the treatment of patients with single benign thyroid disease of different sizes.Methods:From June 2008 to June 2011, 132 patients with single benign thyroid lesion in the Second People′s Hospital of Changshu were selected as observation group.According to the size of the lump, 132 patients with single benign thyroid disease were divided into two groups ≤2cm group(64 patients) and >2cm group(68 patients). In addition, 62 patients with single benign thyroid lesion underwent subtotal thyroidectomy at the same time were randomly selected as control group.The incision size, operating time, intraoperative blood loss, postoperative drainage volume, hospital day, hospital cost and postoperative complications (hoarseness, water bucking, low calcium, hypothyroidism, tumor recurrence) of the two groups were recorded and compared with the control group.Results:The incision size, operating time, intraoperative blood loss, postoperative drainage volume, hospital day, hospital cost of ≤2cm group were less or shorter than those of the control group[(3.6±0.4)cm vs.(4.5±0.6)cm, (40.1±9.6)min vs.(76.2±15.3)min, (52.2±17.8)mL vs.(82.1±16.8)mL, (49.8±15.7)mL vs.(78.1±12.4)mL, (4.9±0.9)d vs.(6.1±1.2)d, (7125.2±219.4)CNY vs.(8321.2±308.1)CNY, t=9.935, 15.917, 9.690, 11.205, 6.363, 25.161, all P<0.05]. The incidence of postoperative hoarseness in ≤2cm group was lower than that in the control group[0.0%(0/132) vs.6.5%(4/62), χ 2=4.4244, P<0.05]. The incidence of postoperative hypothyroidism in ≤2cm group was lower than that in the control group[0.0%(0/132) vs.8.1%(5/62), χ 2=5.374, P<0.05]. The incidences of postoperative water bucking, low calcium and tumor recurrence of ≤2cm group had no statistically significant differences compared with those of the control group (χ 2=2.097, 1.040, 0.968, all P>0.05). The operating time, hospital cost of >2cm group were less than those of the control group[(49.6±12.7)min vs.(76.2±15.3)min, (7 641.6±382.4)CNY vs.(8 321.2±308.1)CNY, t=10.820, 11.090, all P<0.05). The incision size, intraoperative blood loss, postoperative drainage volume, hospital day of ≤2cm group had no statistically significant differences compared with those of the control group( t=1.740, 1.709, 1.850, 1.487, all P>0.05). The incidences of postoperative hoarseness, water bucking, low calcium and hypothyroidism of ≤2cm group had no statistically significant differences compared with those of the control group (χ 2=2.175, 0.443, 1.105, 1.670, all P>0.05). The patients were followed-up for 7-10 years, the postoperative recurrence rate in >2cm group was higher than that in the control group[10.3%(7/68) vs.1.6%(1/62), χ 2=4.232, P<0.05]. Conclusion:Compared with conventional subtotal thyroidectomy, extended lumpectomy in the treatment of patients with small single benign thyroid disease(≤2cm) has good effect.The incision size, operating time, intraoperative blood loss, postoperative drainage volume, hospital day, hospital cost, postoperative hoarseness and postoperative hypothyroidism are less than subtotal thyroidectomy.And it don't increase tumor recurrence rate of ipsilateral thyroid gland.So it is worthy of clinical application.But it is not suitable for larger single benign thyroid disease (>2cm) because of higher recurrence rate.