Comparison Of Drainage Fluid Analysis And Body Trauma After Endoscopic And Open Near Total Thyroidectomy

Objective:In the middle and young patients receiving near total thyroidectomy,the flow rate of the incision,the difference of the basic components in the drainage fluid,and the degree of the systemic inflammatory response to the body were compared to explore the difference between the two methods of endoscopic thyroidectomy and traditional open thyroidectomy by breast approach,and to provide a basis for the selection of appropriate surgical methods.MethodsIn this prospective randomized clinical controlled study,we selected 71 cases who first underwent near total bilateral thyroidectomy as the research object.According to the operation mode,the patients can be divided into endoscopic surgery group(group A)and open surgery group(group B),and Group A collected 38 patients and 33 patients in group B in the same period of time.The total drainage volume after operation,the time of postoperative extubation,and postoperative daily drainage volume were respectively counted after operation.We tested the content of triglyceride(TG)and total protein(TP)in postoperative drainage fluid on the first day.Meanwhile,the content of Interleukin-6(IL-6),high sensitive C reactive protein(HS-CRP),alpha 1-acid glycoprotein(AAG),ceruloplasmin(CER)and haptoglobin(HPT)in veinal blood of the morning were tested before the operation and on the first day after surgery.In using statistical methods,the changes of the above indexes before and after operation in the same group,and the difference of these indexes between the two groups were compared and analyzed.Results1.The total drainage volume after operation of Group A was 208.05±86.06ml and Group B was 99.45±47.22ml,there was significantly different between the two groups(t=6.703,P<0.01);The average postoperative extubation time of Group A was 4.45±1.22 days,and Group B was 2.91±0.88 days,there was statistically significant between the two groups(Z=-4.987,P<0.01);As for the postoperative day drainage,group A was more than group B every day at the same time(t=3.906、5.416、4.597、3.394,P<0.01),the trend of daily variation of the two groups decreased gradually,and the decrease trend was most obvious in the first day after surgery,and then the decrease trend of daily drainage fluid slowed down.2.The contents of triglyceride and total protein in the drainage fluid of Group A were 2.429±1.514mmol/l and 43.314±6.625g/l in the first day,Group B were respectively 2.017±0.804mmol/l and 45.494±8.605g/l,there was no statistically significant difference between the two groups(t= 1.417,P=0.162;t=-1.170,P=0.246);Compared with normal population,TG content in drainage fluid increased and TP content decreased.3.In the group A or group B,compared with before operation,the content of Alpha 1-acid glycoprotein,ceruloplasmin or haptoglobin in veinal blood on the first postoperative day was no significant difference(P>0.05),but the venous blood levels of Interleukin-6 and high sensitive C reactive protein were significantly different between the first postoperative day and the preoperative day(Group A:Z=-5.159,P<0.01;Z=-5.160,P<0.01.Group B:Z=-4.597,P<0.01;Z=-4.022,P<0.01).Compared between the two groups,the contents of Interleukin-6 and high sensitive C reactive protein were 16.689±16.190ng/l and 9.422±6.609mg/l in Group A on the first day,and Group B were respectively 26.058±24.514ng/l and 12.063±8.850mg/l,there was no significant difference in comparison between the two groups(Z=-1.660,P＝0.097;t=-1.395,P=0.168).In group A,the difference between the IL-6 content of venous blood and the preoperative difference(AIL-6)was 14.163±16.362 ng/L,and the group B was 18.988±20.361 ng/L,and there was no significant difference between the two groups(Z=-0.803,P=0.422).In group A,the difference between the HS-CRP content of venous blood and the preoperative difference(AHS-CRP)was 7.671±5.789 mg/L,and the group B was 8.195±10.172 mg/L,and there was no significant difference between the two groups(t=-0.260,P=0.796).Conclusion1.Compared with open near total thyroidectomy,for people under 65 years of age,the volume of postoperative drainage increased and the time of extubation was prolonged after endoscopic surgery.2.Compared with open surgery,the basic composition of drainage fluid in endoscopic surgery is similar.3.Although endoscopic thyroidectomy has a larger wound,compared with open surgery,they are similar to the body’s systemic trauma response.4.Endoscopic surgery is one of the conventional options for patients with neck no scar requirement and those middle-aged and young people,especially benign thyroid nodules.