A Comparative Study Of Three-dimensional Laparoscopic Applied To Differentiated Thyroid Cancer

Objective:At present,there are two types which are traditional open surgery and laparoscopic operation for the treatment of thyroid carcinoma.The laparoscopic surgery is divided into two-dimensional and three-dimensional techniques.The three-dimensional laparoscopic using in the surgical treatment is widely recognized.However,there are few clinical studies on its application in thyroid cancer.And we can have no evidence to reflect the advantages of 3D laparoscopic using in the treatment of thyroid cancer.So in this study,we compared the 3D endoscopy,2D endoscopy and open surgery on the clinical efficacy of differentiated thyroid carcinoma,and its effect on the inflammatory response of the body.To explore the value of 3D laparoscopy in total thyroidectomy combined with central lymph node dissection.Methods:The clinical data of 90 patients with differentiated thyroid carcinoma who underwent radical thyroidectomy from September 2013 to April 2016 were retrospectively analyzed.The patients were admitted to the general department of the Southern Medical University,Zhujiang Hospital.The patients were divided into three groups:3D laparoscopic group,2D laparoscopic group and open group,with 30 cases each group.The shortlisted cases were all diagnosed as differentiated thyroid carcinoma by postoperative paraffin pathological.The laparoscopic groups were operated via areola breast approach,and the traditional open surgery group was operated with low neck collar incision.The perioperative related clinical indicators(operative time,intraoperative bleeding,postoperative drainage,hospital stay and so on),postoperative adverse reactions and the impact of the body’s inflammatory index were compared among the three groups.And then we use the statistical software to analyze the data and draw the conclusion.Results:We analyze the data with the statistical software and draw the conclusion.Compared with the open group and 2D laparoscopic group,the blood loss in 3D laparoscopic group was less.The incidence of adverse reactions was lower in the 3D laparoscopic group than that in the open group,and the incidence of discomfort was lower in the patients with dizziness and vomiting,and in the 3D laparoscopic group,there was no case of patients with voice hoarse or coughing which are the major complications happening in thyroid surgery.The operation time in 3D group was shorter than that in 2D group(P<0.05).With an average reduction of about 22 minutes.There was no difference in total hospitalization expenses between the two laparoscopic groups.The total cost of hospitalization in 2D group was about 18050 ±129 yuan,and the total cost of hospitalization in 3D group was about 19675 ± 1147 yuan.Compared with the 2D laparoscopic group,the 3D group would not increase the cost of hospitalization.There was no statistically significant difference between the 3D group and the other two groups in the postoperative drainage.The postoperative hospital stay,the number of lymph nodes dissection,the positive rate of lymph nodes and the inflammatory response to the three groups were not statistically significant(P>0.05).Conclusion:The 3D laparoscopic using in total thyroidectomy combined with central lymph node dissection is safe and effective.Compared with the traditional 2D laparoscopic and open surgery group,it can significantly reduce the amount of intraoperative blood loss.And compared with the 2D laparoscopic surgery,it can greatly reduce the operation time and will not increase the patient’s additional financial burden.Compared with the open surgery group,the 3D group can significantly reduce the incidence of perioperative adverse reactions.Most people think that laparoscopic thyroid surgery will increase the trauma to the body because it needs to widely separate the subcutaneous tissue.The results showed that there was no significant difference in inflammation between the laparoscopic group and the open group,suggesting that laparoscopic surgery did not increase the trauma of patients.Therefore,3D laparoscopic surgery can reduce intraoperative blood loss,can reduce the incidence of perioperative adverse reactions after surgery,and with cosmetic effect and little influence on inflammatory response.It can be used as an important surgical option for differentiated thyroid cancer.