A Clinical Comparative Study Between Endoscopic Thyroidectomy By Breast Approach And Conventional Open Thyroidectomy

Obiective:This study compared between endoscopic thyroidectomy via breast approach with traditional thyroidectomy by the operative time, intraoperative blood loss, postoperative analgesics usage, postoperative length of stay, postoperative drainage, hospitalization costs, drainage days, postoperative cosmetic results, postoperative complications,to explore endoscopic thyroidectomy was the clinical cosmetic results,security, and minimally invasive.Method:Our hospital female patients were studied, according to inclusion and exclusion in the selection. From Jan 2007 to Dec 2009, there are 91 cases were implemented thyroidectomy,43 cases were underwent endoscopic thyroidectomy,23 cases of unilateral patients,20 cases of bilateral group of patients; and 48 cases were underwent traditional opening thyroidectomy,23 cases of unilateral patients,25 cases of bilateral group of patients; Both groups was performed by the same doctors and was general anesthesia with endotracheal intubation, two groups were performed the majority of unilateral or bilateral thyroid resection; we compared the two kinds of surgical operation time, intraoperative blood loss, postoperative analgesic usage, postoperative length of stay, postoperative drainage, drainage days, hospitalization costs, postoperative cosmetic results, postoperative complications and recurrence rate. And the value of P<0.05 was considered to be statistically significant.All the statistical analysis were completed by SPSS 11.0.Result:All patients had successful surgery, two groups had no severe complications such as postoperative bleeding, injuries of the recurrent or superior laryngeal nerve, parathyroid injury. endoscopic group were no conversion to open surgery, no postoperative local skin bruising, swelling and chest forced symptoms.①Operative time:ET group:unilateral group(90.5±22.4)min,bilateral group(128.6±28.7)min; OT group:unilateral(83.4±24.1)min,bilateral group(100.2±36.6)min;both unilateral and bilateral groups were no significant difference.②Intraoperative blood loss:ET group unilateral group(23.9±9.9)ml,bilateral group(33.0±10.0)ml; OT group:unilateral group(33.3±8.4)ml,bilateral group(44.6±10.7)ml,both unilateral and bilateral groups were significant difference.③Postoperative analgesia:ET group:unilateral group 6 cases, bilateral group 9 cases and OT group:unilateral group 8 cases, bilateral group 10 cases, both unilateral and bilateral groups were no significant difference. ④Postoperative hospital stay:ET group:unilateral group(5.3±1.6)days,bilateral group (5.3±1.6) days; OT group:unilateral (5.2±2.2)days, bilateral group (6.0±2.6) days;both unilateral and bilateral groups were no significant difference.⑤Postoperative drainage volume:ET group:unilateralgroup(31.0±11.4)ml,bilateral group (41.9±10.4)ml and OT group:unilateral group(26.8±9.3)ml,bilateral group(36.1±10.5)ml, both unilateral and bilateral groups were no significant difference.⑥Drainage days:ET group:unilateral group(2.2±1.0)days,bilateral group(2.3±1.2)days;OT group: unilateral (1.9±0.8)days, bilateral group (2.2±1.1) days; both unilateral and bilateral groups were no significant difference.⑦Hospitalization costs:ET group unilateral group(8841.7±902.1)yuan,bilateral group(9303.6±1044.5)yuan;OT group:unilateral(7958.1±1137.9)yuan,bilateral group(8419.2±958.8)yuan; both unilateral and bilateral groups were significant difference.⑧The cosmetic results:ET group were all satisfactory; OT group:unilateral group 10 cases, bilateral group 10 cases, both unilateral and bilateral groups were significant difference.Conclusion:Both breast approach endoscopic thyroidectomy and conventional open thyroidectomy are safe and effective. Endoscopic thyroidectomy have the desired cosmetic effect, with the incomparable advantages of traditional opening thyroid surgery, Endoscopic thyroidectomy should be exemplary of the surgery for a clear indication of the patients.