The Clinical Application Of Scarless Endoscopic Thyroidectomy In The Treatment Of Papillary Thyroid Microcarcinoma

Objective: To study the safety and feasibility of scarless endoscopic thyroidectomy in the treatment of papillary thyroid microcarcinoma by comparing the difference of the related factors between scarless endoscopic thyroidectomy and traditional open thyroidectomy in the treatment of papillary thyroid microcarcinoma.And to investigate the clinical value of the treatment of papillary thyroid microcarcinoma of SET.Methods: The research aimed at implementing analysis for 42 cases whom undertook first-time surgery with preoperative diagnosis is PTMC from June 2015 to December 2016 in the first affiliated hospital of Wannan Medical College.Forty-two patients were divided into two groups.The observation group was treated with SET and the control group was treated with TOT.To compare operation time,postoperative extubation time,bleeding volume,postoperative complications,the serum inflammatory factors(TNF-?,IL-17),VAS score(24 hours after the operation),the number of lymph node dissection and postoperative lavage find tumor cells,postoperative local recurrence situation,the hospitalization time and cost between the two groups.And we made chi-square test or t test by using SPSS 20.0 to analyze the data in order to study the differences between the two groups.Results: All the operation were successfully completed.One of the observation group was benign thyroid tumor through intraoperative pathology,and did not participate in the analysis of the results.There was no significant difference in postoperative extubation time and lymph node dissection(P> 0.05).There was no tracheal injury,esophageal injury,mediastinal emphysema,intraoperative bleeding,high carbonemia and other serious complications.There was no significant difference in postoperative complication between the two groups(P> 0.05).The operation time of the SET group were significantly higher than those of the TOT group(P <0.01).The VAS score and intraoperative bleeding were significantly lower than the TOT group(P <0.01).The concentration of IL-17 in SET group of the third day was lower than that in the first day after operation(P <0.01).The concentration of IL-17 in TOT group of the third day was lower than that on the first day after operation(P <0.01).There was no significant difference in the concentration of IL-17 between the SET group and the TOT group(F=0.039,P=0.844).The concentration of TNF-? in SET group of the third day was lower than that on the first day after operation(P <0.01).The concentration of TNF-? in TOT group of the third day was lower than that on the first day after operation(P <0.01).There was no significant difference in TNF-? concentration between SET group and TOT group after operation.There was no significant difference in TNF-? concentration between the two groups(F=0.593,P=0.446).SET group of patients with surgery,surgical cavity after surgery were not found in the tumor cells.There was no significant difference in hospitalization time,while hospitalization cost of the SET group were significantly higher than those of the TOT group(P <0.01).Two groups of patients were followed up for one month and three months after operation.Thyroid function and thyroid ultrasonography were performed.No postoperative local recurrence or lymph node metastasis was found.Conclusion: For PTMC patients,SET can achieve the same surgical scope and therapeutic effect as the traditional open surgery,and the cosmetic effect is good.SET does not increase the trauma of the operation when the PTMC is treated.Endoscopic thyroid surgery Treatment can be used for PTMC,is a safe surgical approach,can be applied in clinical application.