Clinical Cpmparision Of Total Laparoscopic Radical Resection Of Thyroid Micropapillary Carcinoma And Open Surgery

Objective: To compare the clinical effects of total laparoscopic radical thyroid carcinoma and radical thyroid micropapillary radical resection,and to explore the safety,feasibility and practicability of the operation.Methods: Collection of 102 patients with thyroid micropapillary carcinoma who met the inclusion criteria and exclusion criteria from September 2016 to October 2017 in the Department of Otorhinolaryngology Head and Neck Surgery of the Loudi Central Hospital affiliated to Nanhua University,including total thyroid micropapillary thyroid Forty-three patients with radical cancer surgery(experimental group)and 59 patients with open surgery(control group)were compared.The operation time,intraoperative blood loss,incision drainage on the first day after surgery,and VAS pain within 24 hours after surgery were compared between the two groups.The scores,postoperative hospital stay,number of lymph node dissections in the central region,the rate of recurrent laryngeal nerves and parathyroid glands,and the satisfaction of postoperative incision cosmetic satisfaction.Results:1.The operation time of the total laparoscopic group and the open group were(75.19±7.61)min and(59.68±6.27)min,respectively(P <0.05).The intraoperative blood loss was(8.69±2.33)ml and(7.86±1.02,respectively).)ml,(P<0.05);the incision drainage volume on the first day after surgery was(27.09±8.54)ml and(15.35±4.64)ml,respectively(P <0.05),and the postoperative hospital stay was(6.30±1.02).d and(4.91 ± 1.17)d,(P < 0.05).There was a statistically significant difference between the two groups in the above results.It indicated that the total operative group had more bleeding volume and longer operation time than the open group.The first day after surgery,the incision drainage volume was longer and the postoperative hospital stay was longer.2.The VAS pain scores in the total laparoscopic group and the open group were(4.42±1.19)points and(4.68±1.07)points,respectively(P > 0.05);the central lymph node dissection scores were(5.21±2.35).The sum of(5.27±2.22),(P >0.05),the difference between the two groups was not statistically significant.There was no significant difference in the VAS pain score and the number of central lymph node dissections between the laparoscopic group and the open group within24 hours after surgery.3.Recurrent laryngeal nerve and parathyroid injury rate: 2 cases of hoarseness occurred in the total laparoscopic group,accounting for 4.65%,1 case of open surgery group,accounting for 1.69%,no statistical comparison between the two groups Learning significance(P > 0.05);1 case of hypocalcemia occurred in the total laparoscopic group,accounting for 2.33%.No postoperative hypocalcemiaoccurred in the open group.No permanent laryngeal resection was observed in either group.There were no significant differences in the symptoms and signs of nerve and parathyroid injury(P > 0.05).4.Postoperative incision cosmetic satisfaction survey showed that 16 patients in the total laparoscopic group were very satisfied,accounting for 37.21%,22 patients were satisfied,accounting for 51.16%,and overall satisfaction was88.37%.Two patients in the open group were very satisfied.The results were3.39%,9 cases were satisfactory,accounting for 15.25%,and overall satisfaction was 18.64%.The results were statistically significant(P < 0.05),indicating that the total laparoscopic group was significantly more satisfied with postoperative cosmetic satisfaction than the open group.Conclusion: 1.The laparoscopic group can achieve the same central lymph node dissection as the open group,but its long-term effect needs further follow-up study;2.In the laparoscopic group,the operation time was longer,the intraoperative blood loss was slightly increased,the incision drainage volume was higher on the first day after surgery,the postoperative hospital stay was longer,and the postoperative incision cosmetic satisfaction was significantly increased.There was no significant difference in the degree of pain,the number of central lymph node dissection,the recurrent laryngeal nerve,and the rate of parathyroid injury.3.Total laparoscopic thyroid micropapillary cancer radical surgery clinical practice is safe and feasible,for young patients with high requirements for low-riskthyroid micropapillary cancer can be considered as the first choice.