Efficacy observation of unilateral radical thyroidectomy via axillary approach endoscope without air insufflation / 肿瘤研究与临床

ABSTRACT

Objective:To explore the curative effect and safety of unilateral radical thyroidectomy via axillary approach endoscope without air insufflation.Methods:The clinical data of 80 patients with unilateral thyroid cancer in Huaibei People's Hospital in Anhui Province from June 2017 to June 2019 were retrospectively analyzed. The patients were divided into the control group (40 cases) and the observation group (40 cases) according to the surgical method. The observation group was treated with unilateral radical thyroidectomy via axillary approach endoscope without air insufflation, and the control group was treated with open surgery plan. The dissection number of lymph nodes in the central area, the time of flap separation and cavity establishment, the total operation time, the drainage volume and the days of hospital stay in patients of two groups were recorded, and the postoperative complications were evaluated and recorded. The neck and chest pain of patients were investigated with visual analogue scoring method (VAS) at 3 days, 1 month and 3 months after surgery. The white blood cell count (WBC), interleukin 6 (IL-6) and C-reactive protein (CRP) levels were measured before and 24 hours after treatment. The cosmetic satisfaction of the patients was investigated at 3 months after surgery.Results:The time of flap separation and cavity construction, total operation time, drainage volume and hospitalization days in the observation group were (34.27±4.38) min, (130.75±12.28) min, (143.49±15.48) ml, and (7.21±1.95) days, and they were (12.43±1.83) min, (90.38±8.65) min, (87.48±12.11) ml, and (5.48±1.32) days in the control group, and the differences between the two groups were statistically significant ( t values were 29.098, 17.002, 18.024, and 3.576, all P < 0.01). The VAS score of chest pain in the observation group was higher than that in the control group at 3 days after surgery ( P < 0.05); the CRP and WBC levels in the observation group were lower than those in the control group at 24 hours after treatment (both P < 0.05). The cosmetic satisfaction rating grade in the observation group was 6 cases of grade Ⅰ, 31 cases of grade Ⅱ, 2 cases of grade Ⅲ and 1 case of grade Ⅳ, and there were 1 case of grade Ⅰ, 10 cases of grade Ⅱ, 24 cases of grade Ⅲ and 5 cases of grade Ⅳ in the control group, the cosmetic satisfaction of the observation group was better than that of the control group ( P < 0.05). There was no significant difference in the incidence of postoperative wound infection, temporary recurrent laryngeal nerve paralysis and subcutaneous hematoma between the two groups (all P > 0.05). Conclusion:The radical thyroidectomy via axillary approach endoscope without air insufflation has good therapeutic and cosmetic effects, and it can effectively reduce the inflammatory response in patients.