Comparison Of Breast Approach Endoscopic Thyroidectomy And Conventional Open Thyroidectomy

Objective To compare the clinical effect of breast approach endoscopic thyroidectmy and traditional open thyroidectomy,discuss the clinical efficacy and its value of breast approach endoscopic thyroidectmy.Method The clinical dates of 93 patients with thyroid nodules who receive treatment in department of thyroid and breast surgery of Lishui Central Hospital of Zhejiang from December 2014 to November 2016 were retrospectively analyzed,45 patients among them were went though breast approach endoscopic thyroidectmy,the other underwent the traditional open thyroidectomy.The operation time,intraoperative blood loss,postoperative drainage volume,removal time of drainage tube,postoperative hospital stay,incision length,postoperative pain score,postoperative complications and incision satisfaction were compared and analyzed between the 2 groups.Results All the cases were successfully completed and done by the same operator,the endoscopic group without conversion to conventional procedure.The operation time in endoscopic group compared to open group with significant difference[(122.53±33.17)min vs(99.40 ± 11.60)min,t=4.55,P=0.00 ].The Intraoperative blood loss[(34.69±9.84)ml vs(43.77±11.50)ml,t=4.08,P=0.00]and postoperative drainage volume [(101.67 ± 25.22)ml vs(66.35 ± 11.82)ml,t=8.73,P=0.00 ] compared in endoscopic group and open group with significant difference.The postoperative pain score[(2.93±0.80)vs(3.94±0.99),t=5.40,P=0.00]and incision length[(3.33±0.17)cm vs(6.69 ± 0.97)cm,t=22.76,P=0.00 ] compared in two groups have no significant difference.Incision satisfaction in endoscopic compared with open group with significant difference(Z=8.63,P=0.00).However,there were no significant difference between the two groups in Removal time of drainage tube [(75.64 ±11.98)h vs(73.33±11.13)h,t=0.97,P=0.34],postoperative hospital stay[(80.67±13.33)hvs(81.73±11.78)h,t=0.22,P=0.68]and postoperative complications(χ2=2.35,P=0.13).Conclusion Although breast approach endoscopic thyroidectomy compared with traditional open thyroidectomy for a longer operation time and more postoperative drainage volume,but the endoscopic group with less bleeding and pain in patients with a low degree,short length of incision,higher patient satisfaction,and postoperative complications of two groups had no difference,it show that the breast approach endoscopic thyroidectomy is a kind of thyroid surgery with better clinical efficacy and cosmetic results.