Clinical Study Of SET And TOT In The Treatment Of Thyroid Papillary Carcinoma

Objective: To compare the clinical efficacy of Traditional Open Thyroidectomy and Scarless Endoscopic Thyroidectomy in the treatment of thyroid micropapillary carcinoma,and to explore the safety and feasibility of Scarless Endoscopic Thyroidectomy and Traditional Open Thyroidectomy in the treatment of thyroid papillary carcinoma.To inquire the clinical value of the methods in two different surgical treatments of thyroid papillary carcinoma.Methods: 189 patients with thyroid micropapillary carcinoma diagnosed by the Department of Thyroid and Breast Surgery of The First Affiliated Hospital of Wannan Medical College from October 2013 to June 2020 were divided into two groups: traditional open thyroidectomy group and Scarless Endoscopic Thyroidectomy group.There were 83 cases in the Traditional Open Thyroidectomy group and 106 cases in the Scarless Endoscopic Thyroidectomy group.The preoperative diameter,pathological diameter,duration of operation,postoperative drainage,postoperative complications,the number of lymph nodes dissected,the number of metastatic lymph nodes,and the recovery of thyroid function after follow-up were compared and analyzed between the two groups.T-test was performed with SPSS 2.0 statistical software to explore their differences.Results: There were no significant differences in preoperative ultrasonographic diameter,intraoperative lymph node dissection number,postoperative pathological findings of tumor diameter,cervical lymph node metastasis number and postoperative complications between the two surgical methods(P < 0.01).Among the two operation methods,The operation time of SET group was significantly prolonged(P < 0.05)and the postoperative drainage volume was significantly higher than that of TOT group(P < 0.05).The SET group had relatively few postoperative complications.The levels of inflammatory cytokines TNF-α and IL-17 were measured on the first and third day after the two operations,respectively,and the results showed that the levels of TNF-αand IL-17 decreased.The difference was statistically significant.However,the changes of TNF-αand IL-17 after the operation were not statistically significant.No exfoliated tumor cells were found in postoperative lavage fluid in both groups.As for the dynamic monitoring of TSH,FT3 and FT4 after operation,there was no significant difference between TOT and SET(P < 0.05).Conclusion: For patients with early thyroid papillary carcinoma,SET radical thyroidectomy can achieve the same surgical range as TOT’s operation,and complete dissection of central lymph nodes.It is a safe and effective way to achieve the cosmetic effect of traceless neck.The postoperative complications were less.So it should be widely used in clinical practice.