Comparative study on the curative effect and safety of endoscopic micro-papillary carcinoma thyroid surgery through oral vestibule and chest-breast approaches
Li Zhihong1, Tan Yihong2, Liang Weixin1
1Department of General Surgery, People's Hospital in Gaoming District, Foshan 528500, China; 2Department of Thyroid Vascular Surgery, Nanhai Hospital Affiliate to Southern Medical University, Foshan 528200, China
Abstract：Objective To explore the curative effect and safety of endoscopic thyroid micro-papillary carcinoma surgery through oral vestibule and chest-breast approaches. Methods The clinical data of 110 patients (14 males, 96 females) with thyroid micro-papillary carcinoma who were admitted to Nanhai Hospital Affiliate to Southern Medical University between June 2017 and June 2019 were retrospectively analyzed. Their average age was 18-59 (35.19±6.89) years. According to different surgical methods, they were divided into oral vestibule approach surgery group (trans-oral group, n=55) and chest-breast approach surgery group (trans-chest-breast group, n=55). Baseline data, surgical situation, C-reactive protein (CRP), white blood cell count (WBC), incidence of complications, satisfaction, and aesthetics before and after surgery of the groups were compared. Results No significant differences in baseline data (gender, age, patient, and tumor diameter) were observed between the groups (all P values＞0.05). Endoscopic thyroid surgery was successfully completed in trans-oral group, while 3 patients in trans-chest-breast group were transferred to open surgery. The dissection time of central lymph nodes, total length of incision, and postoperative drainage volume in the trans-oral group were (30.21±4.62) min, (0.28±0.07) cm, and (50.26±16.03) mL, respectively, which were lower than those in the trans-chest-breast group ([35.52±6.91] min, [1.91±0.21] cm, and [73.17±19.53] mL, respectively; t=4.696, 54.465, and 6.648; all P values＜0.01). The dissection number of central lymph nodes in trans-oral group was higher than that in the trans-chest-breast group (8.74±2.03 vs. 5.31±1.22, t=10.518, P＜0.01). After surgery, no significant differences in CRP and WBC were observed between the two groups (all P values＞0.05). The incidence of temporary lips numbness in the trans-oral group was higher than that in the trans-chest-breast group (40.00% vs. 0.00%), whereas the incidence of temporary local numbness in the anterior chest wall was lower than that in the trans-chest-breast group (0.00% vs. 21.15%, all P values=0.000). The scores of satisfaction and aesthetics in the trans-oral group were (9.06±0.75) points and (9.21±0.63) points, higher than those in the trans-chest-breast group ([8.61±0.84] points and [7.81±1.13] points, respectively; t=2.926, 7.972; all P values＜0.01). Conclusions The number of removed central lymph nodes was higher and spending time was shorter with endoscopic thyroid surgery through oral vestibule approach than those achieved with endoscopic thyroid surgery through chest-breast approach. Thus, endoscopic thyroid surgery through oral vestibule approach can meet the cosmetic needs of patients and ensures a curative effect, thereby guaranteeing high patient satisfaction.
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Li Zhihong, Tan Yihong, Liang Weixin. Comparative study on the curative effect and safety of endoscopic micro-papillary carcinoma thyroid surgery through oral vestibule and chest-breast approaches. Chinese Journal of Anatomy and Clinics, 2021, 26(2): 209-213.
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2021, Vol. 26 
