Clinical Comparative Study Of Endoscopic Thyroidectomy Via Air-free Transaxillary Approach And Traditional Anterior Cervical Open Surgery

Objective:To compare the clinical effects of endoscopic thyroidectomy and traditional anterior cervical open thyroidectomy by air-free transaxillary approach.Methods:A total of 62 patients with unilateral thyroid tumors who underwent surgery in The Third the People’s Hospital of Bengbu from January 2020 to February 2021 were collected according to the pre-set inclusion and exclusion criteria.According to different surgical approaches,they were divided into two groups:non-inflatable total endoscopic axillary approach group（n=30）and traditional anterior cervical approach group（n=32）.A retrospective study was used to compare the general data such as age,sex distribution,BMI,tumor diameter and tumor pathological classification between the two groups.The operation time,intraoperative blood loss,number of central lymph node dissection,postoperative drainage,incidenceo of postoperative complications and postoperative hospital stay were compared between the two groups.The incision pain was evaluated by Visual Analogue Score（VAS）.The swallowing function,skin sensation and cosmetic effect of the two groups were compared by telephone and outpatient follow-up 3 months after operation.Use SPSS23.0 software to process the collected data,analyze and draw conclusions.P<0.05 was considered statistically significant.Results:There was no significant difference in age distribution,sex ratio,BMI value,tumor diameter and pathological classification of benign and malignant tumors between the two groups（P>0.05）.The operation time was（105.81±13.51）min in the endoscope group and（78.46±8.55）min in the traditional group,The difference was statistically significant（P < 0.01）.The intraoperative blood loss was（19.00±4.45）ml in the endoscopic group and（24.68±7.12）ml in the traditional group,The difference was statistically significant（P < 0.05）.The total postoperative drainage volume was（127.90±41.16）ml in the endoscopic group and（95.90±12.38）ml in the traditional group,The difference was statistically significant（P < 0.01）.The VAS score of surgical incision on the first day after operation was（2.40±0.98）min the endoscopy group and（3.93±1.12）min the traditional group.The difference was statistically significant（P < 0.01）.On the 3rd day after operation,the VAS score was（1.46±0.91）min the endoscopic group and（1.87±0.80）min the traditional group.One week after operation,the VAS score was（0.80±0.67）min the endoscopy group and（0.93±0.68）min the traditional group.There was no significant difference between the two groups（P>0.05）.Three months after operation,the follow-up results of patient satisfaction:the overall satisfaction rate was 96.67% in the endoscope group and78.13% in the traditional group,and the difference was statistically significant（P<0.05）.There was no significant difference in other research indicators（P>0.05）.Conclusion:The clinical effect of endoscopic thyroid surgery by non-inflatable transaxillary approach is similar to that of traditional anterior cervical open surgery.In the endoscopic group,the incision is more concealed,there is no scar in the neck,there is no obvious discomfort in the anterior region of the neck,the cosmetic effect is significant,and the patient satisfaction is higher.