Comparative Study On The Therapeutic Effect Of Endoscopic Surgery For Thyroid Papillary Carcinoma Through Submental Approach And Transthoracic Breast Approach

Objective: To investigate the efficacy,safety,and feasibility of endoscopic thyroidectomy via submental approach and transthoracic breast approach in the treatment of thyroid micropapillary carcinoma.Materials and Methods: This study included clinical data of patients who underwent endoscopic surgery for thyroid micropapillary carcinoma from October2021 to December 2022 in the Nail Breast Hernia Surgery Department of the Affiliated Hospital of Inner Mongolia University for Nationalities.In both groups of cases,unilateral thyroidectomy was performed,and intraoperative central lymph node dissection was performed after pathological report;After all operations,clinical data of patients were collected and retrospectively analyzed and compared,including:general information of patients,perioperative related indicators,number and time of lymph node dissection,preoperative and postoperative white blood cells,C-reactive protein,erythrocyte sedimentation rate,serum calcium,parathyroid hormone,and other related indicators,as well as postoperative pain degree and score,occurrence of postoperative complications,and postoperative patient satisfaction with beauty.Results: There was no significant difference in general data such as gender and age between the two groups(P>0.05);The time of surgical cavity construction and operation in the submental group was shorter than that in the chest and breast group(P<0.05).The time of cavity construction and operation in the submental group[(16.03 ± 1.91)min,(93.76 ± 2.64)min] was significantly shorter than that in the chest and breast group [(20.23 ± 2.64)min,(108.21 ± 4.20)min](P<0.001).The duration of intraoperative CLND in the submental group [(23.88 ± 1.16)min] was shorter than that in the chest and breast group [(25.91 ± 0.57)min](P<0.05),and the total number of intraoperative CLND in the submental group(9.06 ± 0.62)was greater than that in the chest and breast group(7.86 ± 0.59)(P<0.05).There were no significant differences between the two groups in surgical bleeding,surgical drainage,postoperative hospitalization days,and the number of positive lymph nodes(P>0.05);The VSS score in the submental group was lower than that in the chest and breast group after surgery in both groups(P<0.05).The surgical satisfaction of patients in the submental group was higher than that in the chest and breast group(P<0.05);There was no statistically significant difference in VAS scores between the submental group and the chest and breast group on the 1st,2nd,and 7th day after surgery(P>0.05).Conclusion: 1.Compared with the chest breast group,the submental group has a shorter surgical separation path,which is consistent with the surgical separation range.Tissue separation has less trauma and shorter surgical time;2.Lymph node dissection in the submental group is easier and more thorough than in the chest breast group.3.The submental group has a smaller and more concealed surgical incision than the chest and breast group,effectively reducing trauma,and the incision recovers faster.The patient’s surgical satisfaction is higher.4.Compared with the chest breast group,the submental group effectively avoids complications such as numbness around the chin,nipple,and chest wall,and reduces the risk of surgical site infection.