Clinical Application Research Of Total Endoscopic Thyroidectomy For Differentiated Thyroid Carcinoma

ObjectiveTo explore the clinical efficacy of total endoscopic surgery for DTC by comparing the clinical data of the patients with DTC between totally endoscopic surgery and traditional open surgery.MethodsThe data of 97 patients with DTC performed at department of laparoscopic surgery at the First Affiliated Hospital of Zhengzhou University from October 2010 to September 2017 was retrospectively analyzed.The patients were aged between 19 years old and 45 years old,and 77 women were involved besides 20 men.45 patients were went though breast approach endoscopic surgey,and 52 patients were went through traditional open surgery.According to different surgical methods,it was divided into laparoscopic surgery group and traditional surgery group.The operation time,bleeding volume,drainage volume within 24 hours after operation,extubation time,postoperative hospital stay,hospitalization costs,VAS score,cosmetic satisfaction,and surgical complications were analyzed and compared between the two groups.ResultsThe operations of the two groups were completed successfully,and there was no conversion to traditional open surgery in the laparoscopic surgery group.The operation time in laparoscopic surgery group(188.60±43.99 min)was more than traditional surgery group(139.48±23.43 min),but the bleeding volume in laparoscopic surgery group(30.89±12.35 ml)was less than that in traditional surgery group 46.73±14.91 ml).The difference was statistically significant(P<0.01).The comparing of drainage volume within 24 hours after operation between two groups was also statistically significant(t=3.877,P<0.01),and the drainage volume was(54.33±26.21 ml)and(37.21±14.83 ml)respectively.The extubation time was(43.64±10.18 h)and(42.73±8.74 h)and there was no significant difference between the two groups(t=0.476,P=0.636).The hospitalization time of the two groups were(4.78±1.61 d)and(5.85±1.99 d),the length of hospitalization in laparoscopic surgery group was shorter(t=-2.875,p=0.005).The hospitalization cost in the laparoscopic surgery group increased significantly(t=3.943,P<0.01).The VAS score in laparoscopic surgery group was(2.62±1.01)and that in traditional surgery group was(3.88±1.15),which meant the patients in the endoscopic surgery group with lighter pain(t=-5.713).p<0.01).The cosmetic satisfaction scores were(1.53±0.59 points)and(3.56±0.85 points),respectively.The cosmetic satisfaction of the endoscopic group was higher(t=-13.786,P<0.01).There was no significant difference in the incidence of postoperative complications between the two groups(?2=0.082,P=0.774).Conclusions1.Total endoscopic surgery for DTC has the same safety as traditional open surgery and can complete the dissection of central lymph nodes.It is a completely feasible treatment plan.2.In terms of treatment effect,the total endoscopic surgery group had less bleeding,less pain,quicker postoperative recovery,satisfactory cosmetic results,and there is no increase in the incidence of surgical complications compared with the traditional open surgery group,which is worthy of clinical application.