Effect of small incision endoscopic thyroidectomy on differentiated thyroid cancer and its effect on immunosuppression and tumor indexes / 中国医师进修杂志

ABSTRACT

Objective:To explore the clinical effect of small incision endoscopic thyroidectomy in the treatment of differentiated thyroid cancer (DTC).Method:The clinical data of 63 patients with DTC in Anhui Wanbei Hospital were analyzed retrospectively. According to different surgical schemes, 33 patients who underwent complete endoscopic thyroidectomy were listed as the control group and 30 patients who underwent small oral endoscopic thyroidectomy were listed as the experimental group. The operation and postoperative recovery, immunosuppressive indexes (CD 3+, CD 4+, CD 8+, CD 4+/CD 8+) before operation and on the first and third day after operation, the levels of tumor indexes vascular endothelial growth factor (VEGF), thyroglobulin (Tg) before operation and one month after operation and the incidence of complications were compared between the two groups. Results:Compared with the control group, the operation time in the experimental group was shorter (87.73 ± 15.35) min vs. (102.45 ± 20.78)min, t = 3.171, P = 0.002 ; the amount of intraoperative bleeding in the experimental group was shorter (20.37 ± 5.26) ml vs. (44.25 ± 6.39) ml, t = 16.099, P<0.001 ; the incision length and the postoperative hospital stay in the experimental group were lower (2.03 ± 0.14) cm vs. (2.58 ± 0.18) cm, t = 13.440, P<0.001; (4.58 ± 1.17) d vs. (6.02 ± 1.09) d, t = 5.057, P<0.001; the number of lymph node dissections in the experimental group was more (6.20 ± 1.08) cases vs.(5.12 ± 1.13) cases, t = 3.869, P<0.001.Compared with before operation, the levels of CD 3+, CD 4+, CD 4+/CD 8+ decreased and CD 8+ increased in the two groups on the first day after operation, but the change range in the experimental group was small, and the experimental group recovered to the preoperative level on the third day after operation ( P>0.05). One month after operation, the levels of serum VEGF and Tg in the two groups were lower than those before operation ( P<0.05), but there was no significant difference between the two groups ( P>0.05). There was no significant difference in the incidence of complications between the two groups ( P>0.05). Conclusions:Small incision endoscopic thyroidectomy in the treatment of DTC can achieve the same tumor treatment effect as complete endoscopic surgery, significantly shorten the operation time, reduce incision trauma and intraoperative bleeding, and reduce immunosuppression, which is conducive to postoperative rehabilitation and good treatment safety.