Comparison Of The Efficacy Of Total Thyroidectomy Through Thoracic And Breast Approach With Traditional Open Surgery In Radical Thyroidectomy

Objective: To investigate the safety and efficacy of total thyroidectomy through thoracic and breast approach under total endoscopy in radical resection of thyroid malignancies by comparing the clinical data of total endoscopic thyroidectomy with traditional open surgery in radical thyroidectomy.The advantages and disadvantages of the two different surgical methods were analyzed to provide some reference for the selection of surgical methods in the future clinical treatment.Methods: The clinical data of patients undergoing radical thyroidectomy admitted to the Fourth Clinical College of Medicine of Xinjiang Medical University from June 2019 to May 2020 were retrospectively analyzed.A total of 196 appropriate cases were strictly selected according to the inclusion and exclusion criteria,and divided into 2 groups according to different surgical methods,including endoscopic group(also known as observation group): 79cases;Open group(also called control group): 117 cases.Statistical analysis software(SPSS 23.0)was used to analyze relevant data of patients in the observation group and control group,including: General clinical data(sex,age,lesion size,lesion location),intraoperative data(total duration of operation,surgical blood loss,number of lymph node dissection and number of lymph node metastasis in central region(region VI)),Postoperative clinical data(24-hour drainage volume,total drainage volume,catheter retention time,postoperative hospital stay,cervical and chest pain score 24 H and 48 H after surgery),preoperative and postoperative white blood cell count,serum calcium and parathyroid hormone levels,surgical complications,aesthetic satisfaction 6 months after surgery,and recurrence or metastasis within 2 years.Results: All patients successfully completed the operation,no transfer to open.There were statistically significant differences in gender and age between the two groups(P<0.05).There were no significant differences between the two groups in lesion size,lesion location,number of lymph nodes dissection and metastasis in central region(Region VI),24-hour drainage volume after surgery,total complication rate,recurrence or metastasis within 2 years,preoperative and postoperative white blood cell count,serum calcium and parathyroid hormone levels(P>0.05).Compared with the open group,patients in the endoscopic group took significantly more time to operate,and the difference was statistically significant(P<0.05).However,the surgical blood loss,24 H and 48 H postoperative neck and chest pain scores,total postoperative drainage volume,length of drainage tube retention,postoperative hospitalization days and aesthetic satisfaction 6 months after surgery were better than those of the open group,and the difference between the two groups was statistically significant(P<0.05).Conclusions: Based on this study and related experience of our center,we believe that total endoscopic thyroidectomy through thoracic and breast approach has better safety and clinical efficacy in radical thyroidectomy.Although the thoracic and breast approach takes more time for surgery,it has less trauma to patients,faster postoperative recovery,and more obvious cosmetic effects.Therefore,under the premise of strictly grasping the indications for endoscopic surgery,the clinical efficacy of total endoscopic thyroidectomy through the thoracic and breast approach is superior to that of traditional open surgery,and it is worth promoting.