The Clinical Reaserch Of Total Endoscopic Thyroidectomy Operation Via Chest-breast Approach In Identification Of Parathyroid And Its Function Protection

Objective:To discuss the advantages and disadvantages of total endoscopic thyroidectomy operation via chest-breast approach in identification of parathyroid and its function protection compared with open surgery in thyroid surgery.Methods:35 cases Undergoing total endoscopic thyroidectomy via chest-breast approach and 38 cases in the corresponding period undergoing open surgery of total thyroidectomy and central compartment nodes dissection in Department Of Thyroid Surgery,fujian medical university affiliated union hospital from January 2014 to December 2014 were selected.Data of the two groups in parathyroid hormone(PTH) and serum calcium before operation and the 1st and 3rd day after operation were compared.The number of parathyroid gland were identified,the number of central compartment nodes after operation and the occurrence rate of transient and permanent hypoparathyroidism were compared.Results:The differences of genders,ages, parathyroid hormone(PTH) and serum calcium before operation of the two groups had no statistical significance(P﹥0.05).The identification number of thyroid Was higher in total endoscopic thyroidectomy via chest-breast approach operation group(3.30 士 0.70) than in open surgery group(2.86 ± 0.71). The difference had statistical significance(P<0.05).The level of PTH reduced in the 1st and 3rd after operation. The level of PTH in the 1st of the total endoscopy group(1.05±0.80)is higher than the open group(0.57±0.54). The difference had statistical significance(P<0.05). The level of PTH in the 3rd of the total endoscopy group(1.37±0.70)is higher than the open group(0.81 ± 0.70). The difference had statistical significance(P<0.05).There were less case of transient hypoparathyroidism in total endoscopy operation and the difference had statistical significance(P<0.05).There are no differences of permannent hypoparathyroidism between two groups, it had no statistical significance(P﹥0.05).The number of central compartment nodes after operation of the total endoscopy group is higher than the open group. The difference had statistical significance(P<0.05).Conclusion:Total endoscopic thyroidectomy operation via chest-breast approach is a safe therapy.It has more advantages in parathyroid identification and its function protection compared with open surgery.