Comparative Study Between Modified Miccoli Thyroidectomy And Conventional Thyroidectomy

Objective:Thyroid nodule is a common clinical disease. A survey shows incidence of thyroid nodule is about 20-76%, with thyroid carcinoma accounted for 5%-15%. Most of them are young women. The malignant nodule and a part of benign tumors need surgery.The efficacy and safety of Conventional thyroidectomy (CT) has been recognized. It needs incision in the neck about 5-10cm. Big scar is left after surgery, especially apparent on body with scar constitution. With the continuous development of medical technology and scientific instruments, the endoscopic thyroid surgery has become an effective and safe surgery. Endoscopic thyroid surgery can be divided into completely cavity mirror and modified Miccoli surgery. This article will contrast CT and modified Miccoli on safety, traumatic and beauty to evaluate modified Miccoli surgery.Methods:The study include 82 patients undergoing thyroidectomy at Qilu Hospital of Shandong University in 2013 to 2016. There are 36 patients undergoing modified Miccoli surgery, and 46 patients undergoing the CT. Information about gender, age, operation data, intraoperative and postoperative complications, length of stay, feelings of patients and satisfaction about comesis is collected and analysised. Data were collected from patient medical records, survey, follow-up of outpatient and telephone.Results:Statistic analysis showed no significant difference (P>0.05) between two groups in tumor factors. All the recurrent laryngeal nerves(RLN) of 66 patients were intact and all signals of then showed no injury. There showed a significant difference between two groups in the intraoperative blood loss (26.6±4.99ml vs 47.6±9.88ml, P<0.05). There was significant difference in incision length (2.5±0.36cm vs 7.1±0.85cm P<0.05). Postoperative pain was similar (2.3±0.92 vs 2.0±0.91, P >0.05). The two groups have similar Voice Handicap Index(VHI) (21.6 ±4.39 vs 22.7±3.42, P>0.05). The Reflux Symptom Index (RSI) (23.2 ±7.21 vs 26.1±6.80).There was significant difference in postoperative bleeding(20.2±8.76ml vs 46.8±18.5ml P<0.05). There was no significant difference in postoperative length of stay in hospital (5.0±1.26天vs 4.9±1.28天,P>0.05). Difference was noted in patient satisfaction index about cosmesis (4.2±0.56 vs 3.5±0.86, P<0.05) after 3 month. Conclusion:Compared with conventional thyroidectomy, modified Miccoli in thyroid surgery has some features:(1) It is safe, reliable and effective operation; (2) It has some advantages such as incision is small, quick recovery of activity of neck, minimally invasive, and cosmetology. So the modified Miccoli operation in minimally invasive, restore, cosmetic effect is superior to the conventional thyroidectomy.