The Clinical Study Of Trauma Induced From Endoscopic Thyroidectomy Via Breast Areola Approach

Objective: To evaluate the degree of trauma to the body of endoscopic thyroidectomy via breast areola approach, and to provide evidence for its popularization in clinical work.Methods: 23 patients that received endoscopic thyroidectomy via breast areola approach formed the experimental group, while 21 patients that received open thyroidectomy formed the controlled group. Plasma levels of interleukin-6(IL-6), tumor necrosis factor-alpha(TNF-a), C-reactive protein(CRP), cortisol(CORT), blood glucose(BG), leukocyte differential count(LDC) and body temperature(BT) were measured before and at 4 hours, 24 hours, 48 hours and 72 hours after operation, and to compare the degrees of the related stress responses.The plasma levels of IL-6 and TNF-a were measured with Sandwich enzyme-linked-immuno-sorbent assay(ELISA), the plasma level of CRP was measured with immunonephelometry(INM), the plasma level of CORT was measured with radioimmunoassay(RIA), the plasma level of BG was measured with glucose oxidase method(GO), the plasma level of LDC was measured with laser nephelometry(LN), and the axillary temperature was measured with thermometer.Results: All the experiments were finished except 6 patients quit during the experiments.1. In both of the groups, the IL-6 and TNF-a levels increased to the peak 4 hours after operation (p<0.05), the IL-6 level was still significantly higher than that pre-operative one 72 hours after operation, the TNF-a level decreased to the pre-operative level 72 hours after operation.2. In both of the groups, the CRP level increased significantly 24 hours after operation (p<0.05), and the average level was still higher than the pre-operative one 72 hours after operation.3. In both of the groups, the CORT and BG levels increased to the peak 4 hours after operation (p<0.05), their levels decreased to the pre-operative one 24 hours and 48 hours after operation,respectively.4. In both of the groups, the LDC and BT levels increased to the peak 24 hours after operation (p<0.05), the LDC level was still significantly higher than the pre-operative one 72 hours after operation,and the BT level decreased to the pre-operative one 72 hours after operation.5. There was no significant difference between the parameters by comparison of the two groups as a whole.Conclusions: The endoscopic thyroidectomy via breast areola approach and the open thyroidectomy induced the similar degree of trauma to the body. The anterior deserves popularizing in clinical work because of its cosmetic result.