| Objective To investigate the effect and clinical value of Breast Approach Endoscopic Thyroidectomy for female patients with low risk papillary thyroid carcinoma in T1a,searching a surgical method with the efficacy similar to those of conventional open thyroidectomy when considering short-term therapeutic efficacy,meanwhile it had better cosmetic results for people with this disease.Methods Between January 2015 to June 2017,female patients suspected to be stage T1a thyroid papillary carcinoma due to routine physical examination or imaging examination were randomly divided into two groups according to the single and double admission Numbers.The experimental group underwent BAET,the control group underwent open surgery.A total of 213 patients were confirmed by postoperative pathology as PTMC,119 in the control group and 94 in the experimental group.The outcomes of perioperative period,postoperative complications and cosmetic results were analysed to compare the efficacy of two groups.Results There were no statistically significant differences in age,body mass index,tumor size among 94 patients of the experimental group and 119 patients of the control group(P=0.541,P=0.934,P=0.376).The volume of blood loss during the operation in the experimental group was less than that in the control group,and the difference was statistically significant(P<0.05).The operation time in the experimental group was longer than that in the control group,and the difference was statistically significant(P<0.05).There were statistically significant differences in postoperative amount of drainage,duration of drainage and the length of hospital stay in two groups(P<0.05).There was no statistically significant in lymph node dissection in the control group and in the experimental group(P=0.616).The incidence of postoperative complications in the experimental group was 13.83%,compared with the control group of 14.29%,there was no significant difference in the incidence of complications between the two groups and there were no life-threatening complications in two groups in this study.The pain in the neck and anterior chest wall in the experimental group was lightly than those in the control group on the first postoperative day(P<0.05).On the second and third postoperative days,there were no statistically significant differences in the pain of neck and anterior chest wall in two groups(P=0.138,P=0.520).89 cases in the experimental group were satisfied the cosmetic result after the operation,and the rate was 94.68%;the control group had 92 cases were satisfied the cosmetic result after the operation,and the rate was 77.31%.The postoperative cosmetic effect satisfaction in the experimental group was higher than in the control group,and the difference was statistically significant(P<0.05).The average follow-up of control group was(14.5±7.6)months(6~30months),and the experimental group was(15.7±7.8)months(6~30months),there was no evidences of recurrence and metastasis cases were found in the two groups during the follow-up.Conclusion 1.The short-term efficacy of Breast Approach Endoscopic Thyroidectomy for female patients with papillary thyroid carcinoma was superior to the traditional open thyroidectomy,patients had rapid recovery with less pain reaction in the neck and anterior chest wall,and it has attracted widespread attention because of its satisfactory cosmetic outcome and obvious psychological minimally invasive effect.The wounds were very hidden and protected patients’ privacy of surgical history,improved the quality of life after the operation.Breast Approach Endoscopic Thyroidectomy was a technically feasible and safe procedure for young female patients with papillary thyroid carcinoma.2.However,the volume of drainage after the operation was much more than the traditional open thyroidectomy,the hospital stay was longer and it was more difficult for patients with large tumor or extensive lymph node metastasis.Therefore,BAET should be applied in these patients carefully. |
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