Clinical Comparative Study Between Exposed And Non-Exposed Groups Of Recurrent Laryngeal Nerve In Endoscopic Thyroidectomy Through An Axillary Approach

Objective To discuss the necessity, feasibility and clinical comparative study between the exposed and non-exposed groups of recurrent laryngeal nerve in endoscopic thyroidectomy through an axillary approach in order to enhance the quality and safety of endoscopic thyroid operation.Methods In this section, the study design the writer used is the retrospective analysis study. Select 77 cases of benign thyroid disease patients, operation mode is performed by endoscopic thyroidectomy through an axillary approach. According to the recurrent laryngeal nerve whether exposed or not, the operations were divided into 2 study groups. Among them, the exposed group 49 cases and the non-exposed group 28 cases of clinical data and follow-up data. Summarize and compare two groups of recurrent laryngeal nerve injuries, operation time, amount of bleeding during operation, days of hospitalization, and the incidence of other complications, advantages and disadvantages of two kinds of operation mode, so as to provide the clinical value.Results 77 cases of operation were completed under endoscopic thyroidectomy through an axillary approach, without conversion to conventional open thyroidectomy. Exposure of recurrent laryngeal nerve group:among total 49 cases, no recurrent laryngeal nerve injury, the injury rate is (0%). Non-exposure of recurrent laryngeal nerve group:among total 28 cases,5 cases of recurrent laryngeal nerve injury confirmed by fixation of vocal cord in one side under electronic laryngoscopy, the injury rate is (17.85%).There were statistical differences between these two groups in recurrent laryngeal nerve injury in endoscopic thyroid operations (χ2=9.649, P=0.002< 0.05). Among them, the injury rate of exposed RLN group (0%) is significantly lower than that of non-exposed RLN group (17.85%). The operation time between the two groups (t=-0.195, P=0.846), days of hospitalization (t= 1.423, P= 0.156), mean intraoperative bleeding (t= 1.423, P=0.156) were not statistically significant.Conclusion The exposure of recurrent laryngeal nerve in endoscopic thyroid operations through an axillary approach especially benign thyroid diseases consider can be effective to reduce the recurrent laryngeal nerve injury, at the same time did not increase the incidence of other complications of operation, be safer to operate in endoscopic thyroid operations.