Clinical Comparison Between Complete Endoscopic Thyroid Surgery And Traditional Open Surgery

Objective:To explore the clinical effect of endoscopic thyroid surgery and traditional open thyroid surgery in minimally invasive and cosmetic aspects.At the same time,the difference of pain caused by thyroid surgery between the two groups was analyzed.The aim is to provide a better surgical method for patients to reduce the preoperative psychological burden and accelerate postoperative recovery.Methods:Choose between September 2018 and December 2020,our hospital during the period of117 patients with thyroid disease,surgical treatment,The clinical data of the patients were retrospectively analyzed,the strict into and exclusion criteria,a total of 92 patients into the group screening,and the patients were divided into two groups:thoraco-breast approach endoscopic thyroid surgery group and traditional open surgery group.group into the cavity mirror thyroid surgery group(N=42),5 cases of men and women 37cases,age 29～67.In the conventional surgery group(N=50),there were 7 males and43 females,aged 23-73 years.By comparing the two groups of patient’s age,body mass index(BMI),thyroid disease,type and operation side,lump size,with tube time,duration of surgery,intraoperative blood loss,the total length of the incision,operation of free range,24h drainage volume,postoperative hospital stay,postoperative complications and postoperative 1 month cosmetic effect satisfaction.Visual analogue scale(VAS)was used to score the pain at 1 hour,4 hours,the first day,the third day and the seventh day after surgery.SPSS21.0 software was used to process the research data.To analyze the comparison between endoscopic thyroid surgery and traditional thyroid surgery in terms of minimally invasive and cosmetic and postoperative pain.P<0.05was considered statistically significant.Results:The operation was successfully completed in both groups.In the conventional surgery group and endoscopic group,the operative time[(88.72±15.10)min vs(109.60±17.01)min(P<0.01)],the amount of intraoperative blood loss[(23.50±5.91)ml vs(5.52±2.43)ml(P<0.01)],the total length of the incision[(5.38±0.60)cm vs(2.79±0.25)cm(P<0.01)],Operative free range[(44.25±8.51)cm~2vs(68.91±6.24)cm~2(P<0.01)],24h drainage volume[(44.20±13.30)ml vs(32.62±11.91)ml(P<0.01)],postoperative catheter insertion time[(4.98±0.82)d vs(3.86±0.81)d(P<0.01)],Postoperative hospital stay[(5.04±0.86)d vs(3.93±1.05)d(P<0.01)].Follow-up results one month after surgery showed that the postoperative satisfaction score of endoscopic thyroid surgery was high,and the difference was statistically significant(P<0.01).The pain scores on the first day after surgery[(4.38±0.64)vs(3.60±0.50)(P<0.01)],the pain scores on the third day after surgery[(3.90±0.58)vs(3.31±0.47)(P<0.01)],and the pain scores on the seventh day after surgery[(2.38±0.64)vs(1.69±0.64)(P<0.01)].There were no statistically significant differences in the remaining statistical indicators(P>0.05).Conclusion:Compared with the traditional open thyroid surgery,endoscopic thyroid surgery through breast and breast approach has the same therapeutic effect as the traditional open thyroid surgery,and has quick postoperative recovery,less postoperative pain and better postoperative incision aesthetic effect.Therefore,endoscopic thyroid surgery through breast and breast approach can be used as a safe,aesthetic and less painful surgical method for the treatment of benign thyroid diseases.