A Comparative Study Of The Clinical Efficacy Of Endoscopic-Thyroidectomy By A Gasless Unilateral Axillary And Open Thyroidectomy

Objective:Comparison of clinical efficacy and safety between endoscopic-thyroidectomy by a gasless unilateral axillary and open thyroidectomy in the treatment of papillary thyroid microcarcinoma.Method:The clinical case data of 32 cases of endoscopic-thyroidectomy by a gasless unilateral axillary and 32 cases of open thyroidectomy completed from July 2021 to January 2022 at the Thyroid Clinic of the Second Affiliated Hospital of Nanchang University were retrospectively analyzed by comparing the perioperative data of the general condition data of the two surgical procedures,and postoperative follow-up and investigation was performed for more than 6 months after surgery.The data were analyzed and summarized using SPSS 26.0 statistical software.Results:1.The operative time was 107 min in the endoscopic group and 58 min in the traditional group,(P<0.05);the intraoperative bleeding was 20 ml in the endoscopic group and 28 ml in the traditional group,(P<0.05);The total drainage volume in the endoscopic group was 54 ml in 24 hours postoperatively compared with 38 ml in the traditional group,(P<0.05);the total drainage volume in the endoscopic group was 114 ml compared with 98 ml in the traditional group,(P<0.05).The above results indicate that the endoscopic group had longer operation time,less intraoperative bleeding and more postoperative drainage than the traditional group.2.The total number of lymph nodes cleared in the endoscopic group was 3 and the total number of lymph nodes cleared in the traditional group was 3,(P>0.05);the number of postoperative hospital days was 3 in the endoscopic group and 3 in the traditional group,(P>0.05);the total hospital cost was 21700 yuan in the endoscopic group and 22150 yuan in the traditional group,(P>0.05);indicating that there was no significant difference between the endoscopic group and the traditional group in terms of the number of lymph nodes dissected,postoperative hospital days and costs.3.Temporary hoarseness occurred in 1 case(3.1%)in the endoscopic group and in 3 cases(9.4%)in the traditional group,(P>0.05);subcutaneous petechiae occurred in 1 case(3.1%)in the endoscopic group and in the traditional group,no such complication occurred,(P>0.05);permanent laryngeal nerve injury,postoperative bleeding,wound infection,and lymphatic leakage did not occur in either group,(P>0.05).The difference in the total occurrence of complications between the two groups was not statistically significant,(P>0.05).4.In terms of postoperative follow-up investigations related to quality of life,Swallowing Disorder Index at 1 month postoperatively were 3 in the endoscopic group and 4 in the traditional group,(P<0.05);Swallowing Disorder Index at 3 months postoperatively were 2 in the endoscopic group and 3 in the traditional group,(P>0.05);Voice Impairment Index at 1 month postoperatively was 4 in the endoscopic group and 3 in the traditional group,(P>0.05);Voice Impairment Index at 3 months postoperatively was 3 in the endoscopic group and 2 in the traditional group,(P>0.05);indicating that swallowing discomfort was weaker in the endoscopic group than in the traditional group in the short term after surgery,but both vocal discomfort and swallowing discomfort improved with time,and there was no longer a significant difference between the two groups in the postoperative 3-month survey.In the survey of cosmetic satisfaction at 3 months postoperatively,the satisfaction statistic was 30(93.8%)in the endoscopic group and 17(53.1%)in the traditional group,(P<0.05);the cosmetic satisfaction in the endoscopic group was significantly higher than that in the traditional group.The VSS score at 3 months postoperatively was 5 in the endoscopic group and 6 in the traditional group,(P<0.05);the scar condition was better in the endoscopic group than in the traditional group.The scar self-concern score at 3 months postoperatively was 3 in the endoscopic group and 7 in the traditional group,(P<0.05);the scar self-concern was higher in the traditional group than in the endoscopic group.No tumor recurrence and lymph node metastasis were found in both groups during the postoperative review and follow-up.Conclusion:In the treatment of papillary thyroid microcarcinoma,endoscopic-thyroidectomy by a gasless unilateral axillary is an equally safe and feasible procedure compared to open thyroidectomy.The endoscopic group is comparable to the traditional group in terms of the number of lymph nodes cleared and postoperative complications,and can achieve a more excellent cosmetic result,which helps patients to have a better quality of life.The endoscopic-thyroidectomy by a gasless unilateral axillary has good intraoperative visualization and less bleeding,with the drawback of longer operative time.