Comparison Of The Efficacy Of Submental Approach And Axillary Approach In The Treatment Of Papillary Thyroid Carcinoma With Inflation-Free Endoscopy

Objective: In the different endoscopic approaches for the treatment of papillary thyroid carcinoma,the short-term surgical efficacy of submental approach and axillary approach for the radical resection of thyroid carcinoma with inflation-free endoscopy was compared,so as to provide more clinical reference for the selection of endoscopic approaches for thyroid carcinoma.Methods: This study retrospectively analyzed the clinical data of 122 patients undergoing endoscopic radical thyroidectomy in the Department of Thyroid and Breast Surgery,the First Affiliated Hospital of University of Science and Technology of China from July 2021 to February 2022,including 45 patients undergoing endoscopic thyroidectomy through submental approach(7 cases excluded)and 70 patients undergoing endoscopic thyroidectomy through axillary approach,the recent surgical effects of the two groups were compared and analyzed.Including age,sex,thyroid size and other general clinical data.Perioperative parameters such as the number of lymph nodes dissected,the number of positive lymph nodes,intraoperative blood loss,operation time,hospitalization cost,visual analogue scale of pain at 24 h and 48 h after surgery,drainage volume of the first and second days after surgery,postoperative hospital stay,etc.Complications and discomfort within two weeks after surgery,numbness or tingling sensation in the neck and chest,changes in motion of the neck and shoulder,swallowing discomfort,changes in articulation,and cosmetic satisfaction of incision were compared and evaluated for different endoscopic thyroid cancer surgical approaches two months after surgery.Results: There was no significant difference between the two groups in age,sex,thyroid size,number of dissected lymph nodes,number of positive lymph nodes,intraoperative blood loss,hospitalization cost,visual analogue scale of pain at 24 hours and 48 hours after operation,changes of neck and shoulder motion,changes of pronunciation and cosmetic satisfaction of incision two months after operation.The drainage volume on the first and second day after operation,the days of hospitalization,related complications and discomfort within two weeks after operation,numbness,tingling sensation and swallowing discomfort in neck and chest two months after operation were more than those in submental group,and there were significant differences(P < 0.05).Conclusion: Both submental approach and axillary approach gasless endoscopic radical thyroidectomy have good surgical and cosmetic effects.Compared with the axillary approach,the submental approach has the characteristics of less trauma and rapid recovery,and can complete bilateral thyroidectomy and lateral cervical lymph node dissection.