| Background:Thyroid cancer is one of the most common malignant tumors in the endocrine system.In recent years,with the enhancement of people’s health awareness,more and more asymptomatic thyroid nodules have been found by high-resolution ultrasound.The detection rate of thyroid cancer has increased,and the incidence of thyroid cancer has become higher and higher.There are significant gender differences in thyroid malignant tumors.Female patients are significantly more than male patients.5%-15% of thyroid nodules are thyroid cancer.There are four main pathological types of thyroid cancer: papillary cancer,follicular cancer,medullary cancer and undifferentiated cancer.Differentiated thyroid cancer(DTC)includes papillary thyroid cancer(PTC)and follicular thyroid cancer(FTC),which account for more than 90% of thyroid cancer.Different types of thyroid cancer have different growth patterns.The most common type of thyroid cancer is papillary cancer,accounting for 79%-94% of thyroid cancer.Compared with other malignant tumors,the progression is slow and the patient has a longer survival time.At present,surgery is still an important method for the treatment of papillary thyroid cancer.Open thyroidectomy causes scars in the neck,which affects the beauty of the neck.With the continuous improvement of endoscopic operation technology and the invention and innovation of new instruments,the indications of endoscopic thyroidectomy have gradually expanded from benign tumors to some malignant tumors.Compared with open surgery,laparoscopic thyroidectomy has a good cosmetic effect and has been widely recognized by thyroid surgeons and patients,so that various types of laparoscopic thyroidectomy continue to be skilled,and the total areola approach is the most widely used extracervical approach,while the male anterior thoracic approach mostly chooses breast approach.Objective:To investigate the safety and efficacy of endoscopic thyroidectomy in the treatment of thyroid papillary carcinoma,and to compare the advantages and disadvantages of the two methods,so as to provide reference for clinical work.Methods:From November 2016 to October 2018,114 cases of papillary thyroid cancer,56 cases of endoscopic surgery and 58 cases of open surgery were retrospectively analyzed in the Department of Mammary and Thyroid Diseases,First Affiliated Hospital of Henan University.The following data were collected: gender,age,surgical method,paraffin pathological diagnosis,tumor diameter,operation time,intraoperative bleeding volume,post-operative parathyroid hormone level,number of lymph node dissection in area Ⅵ,number of lymph node metastasis in area Ⅵ,post-operative drainage volume,hospital stay,incidence of complications,and post-operative pain assessment.SPSS22.0 software was used for statistical analysis.Results:There were 56 cases in endoscopy group,54 females and 2 males,aged 23-53 years;58 cases in open group,51 females and 7 males,aged 21-54 years.The operation was successfully completed in both groups,and There was no conversion to open surgery in the endoscopic surgery group.The time of open group was 95(55,145)minutes,shorter than 120(95,185)minutes in Endoscopy Group(P < 0.05);the amount of drainage in open surgery was 81.05 +26.73 ml,less than 134.30 +42.58 ml in Endoscopy Group(P < 0.05);the length of hospitalization in open surgery was 3(2,9)days,shorter than that in Endoscopy Group(P < 0.05);the amount of bleeding during operation and the amount of parathyroid gland after operation was higher in two groups(P < 0.05).There were no significant differences in vegetative level,number of lymph node dissection in Ⅵ region,number of lymph node metastasis in Ⅵ region,incidence of complications and evaluation of pain after operation(P ≥ 0.05).Conclusion:By comparing the clinical data of open and complete endoscopy in the treatment of papillary thyroid cancer,it is found that complete endoscopy is as safe and effective as open surgery in the treatment of papillary thyroid cancer,but long-term follow-up observation is still needed.Endoscopic surgery takes longer time than open surgery and has more drainage after operation,but it has smaller incision and no scar on neck,so it has better cosmetic effect. |
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