Clinical Trial Of The Effect Of Endoscopic Thyroidectomy Via Breast Areola Approach On Systemic Immunity

Objective To study the effect of endoscopic thyroidectomy via breast areola approach on systemic immunity, and to discuss its invasion from the point of immunity.Methods 20 patients undergoing endoscopic thyroidectomy via breast areola approach were allocated to a endoscopic thyroidectomy group, and another 20 patients undergoing traditional open thyroidectomy were allocated to a control group. Venous blood was taken from all the patients at 24h pre-operatively and at 24h and 72h post-operatively for analysis of CD3, CD4+, CD4+ / CD8+, IgG, IgM, IgA, C3, and C4.Results (1) In endoscopic thyroidectomy group, the percentage of CD3 decreased significantly at 24h after surgery (P<0.01) and did not returned to baseline completely at 72h after surgery (P<0.05). Significant decrease at 24h after surgery (P<0.05) and returning to preoperative values at 72h after surgery (P>0.05) in the percentage of CD4+ and the ratio of CD4+ / CD8+ were detected. IgG decreased not significantly at 24h after surgery (P>0.05) and continued to decrease at 72h after surgery (P<0.05). C3 decreased significantly at 24h after surgery (P<0.01) and returned to baseline at 72h after surgery of (P>.05). Not significant decrease at 24h and 72h after surgery was detected in IgM, IgA, and C4 (P>0.05). (2) There was no significant difference between endoscopic thyroidectomy group and control group for each of the immune parameters studied.Conclusions (1) Endoscopic thyroidectomy via breast areola approach seems to be associated with trauma-related immune depression and cell-mediated immunity, humoral immunity and complement are all involved. (2) Compared with traditional open thyroidectomy, endoscopic thyroidectomy via breast areola approach can not preserve postoperative immunity, but does not aggravate the immune depression.