A Comparative Study Of Axillary Approach Endoscopic Thyroidectomy And Traditional Open Thyroidectomy

Objective:To evaluate the clinical safety,feasibility, practicability between the traditional open thyroidectomy and the transaxillary endoscopic thyroidectomy.Methods:According to the inclusion and exclusion criteria,a total of 60 patients from April 2014 to October 2015 otolaryngology head and neck surgery with thyroid diseases were assigned into the axillary approach endoscopic surgery group(n=30)and the conventional open surgery group(n=30)in Loudi Central Hospital.The medical records of all patients were collected and analyzed retrospectively and evaluated surgical outcomes such as intraoperative bleeding,operative time, postoperative cosmetic satisfaction,scar consciousness,postoperative incision drainage,hospital day,hospitalization costs and complications(recurrent laryngeal nerve paralysis, parathyroid injury, etc.) in the TAT grounp compared to the COT group.Results:Two groups of patients successfully underwent thyroidectomy.There was without any serious complications such as no gas vessel injury,no large vessel damage,no permanent hypocalcemia,no hypoparathyroidism,no permanent recurrent laryngeal nerve paralysis,and so on.The following is the two groups of main research aspects:1. The cosmetic satisfaction were sinificantly better in endoscopic group(3.17±1.46)than in the traditional open group(4.90±1.76,p<0.05).2. The scar consciousness were also better in the TAT group(1.67±2.16)than in the COT group(3.10±3.23,p<0.05).3. The operation time was shorter in the COT group(76.27±6.89min) than in the TAT group( 101.83±6.79 min,p<0.05).4. In terms of the intraoperative bleeding,the COT group(54.23±3.48ml)was much more than the TAT group(32.00±2.92 ml,p<0.05).5. The differences of postoperative incision drainage were no statistically significant between the COT group and the TAT group(73.63±4.46 ml vs 74.43±4.49 ml,p>0.05).6. The differences of hospital day were still no statistically significant between the COT group and the TAT group(9.93±0.64 d vs 9967.±0.99 d,p>0.05).7. The mean hospitalization costs of the patients was 13510.75±230.77 yuan in the TAT group and 10106.03±291.42 yuan in the COT group(p<0.05).8. The differences of complications were no statistically significant between the COT group and the TAT group(p>0.05).Conclusions:The endoscopic thyroidectomy via the axillary approach is a safe, feasible and practical method with a perfect cosmetic effect.For selected thyroid disease patients who are anxious for neck scars,endoscopic thyroidectomy via the axillary approach is an excellent surgical option.