Effect Of Endoscopic And Open Thyroidectomy On The Cell Immune System And Stress Response

Objective The difference effect between the endoscopic and open thyroidectomy on the cell-mediated immune system and stress response were observed by counts of CD3, CD4 positive cells and NK cells, quantity of C-reactive protein and the upmost temperature of 3 days post-operation in the study, which had the important theoretics and applied signification for the thyroidectomy methods choice, and could base preparation for the appliance and farther research of the endoscopic thyroidectomy among the hypothyroid tumors patients.Methods The 40 women thyroidectomy inpatients of our hospital were choice based on our standardizes, and the patients were divided into the endoscopic (studied group) and open thyroidectomy (contral group) groups randomly. The peripheral venous blood was collected and the counts of the subgroup of lymphocyte (including CD3, CD4 positive cells) and NK cells were counted, and the concentration of C-reactive protein was measured, before operation and at the 0, 6, 24 hours post-operation, and the upmost temperature of 3 days post-operation was recorded. The difference of the counts of the subgroup of lymphocyte, the concentration of C-reactive protein and the upmost temperature among different treated measures were analyzed by the one-way analysis of variance (ANOVA) using the Dunnett multiple comparisons test, and the operation time and the age was analyzed by the unpaired two-tailed t-test,and it was expressed in the form of x±s . And the value of P<0.05 was considered to be statistically significant. All the statistical analysis were completed by SSPS10.0.RESULTS In levels of T-lymphocytes,NK cells,CRP and temperature ,there were no statistically significant differences between endoscopic and open thyroidectomy. The count of CD3, CD4 cells began to fall gradually at the moment of postoperation, and to manifold at 24hs, but there was no significant difference between the preoperation moment and 24 hours. The count of NK cells in the two groups began to fall gradually at the moment of postoperation, and increase at 6 hours, and come back to the general level at 24 hours. The concentration of CRP began to enhance at the moment of postoperation till the 24 hours. The upmost temperature happened at the first day postoperation, and descend to normal at the third day.CONCLUSION The effect of the endoscopic and open on the cell-mediated immune system and stress response was no significant difference, and endoscopic thyroidectomy was not more minimally invasive than open thyroidectomy.