Comparative study on clinical effects of two kinds of endoscopic single-port thyroid surgery via axillary approach

doi:10.3877/cma.j.issn.1674-3946.2022.01.026

Abstract

Abstract:

Objective

To compare the clinical effect of modified non-inflatable axillary approach and conventional transaxillary endoscopic single hole thyroid surgery.

Methods

A prospective study of 62 patients who underwent thyroid tumor resection from January 2019 to June 2020 were divided into two groups：31 patients who received routine single-hole endoscopic thyroid surgery via axillary approach（conventional group）and 31 patients who received modified non-aerated axillary approach（improved group）. SPSS23.0 was used for statistical analysis. Perioperative indicators，incision pain score，aesthetic satisfaction score and other measurement data of the two groups were represented by（

x ˉ

±s），and independent T test was used. Statistical data of complications were analyzed by χ² test. P<0.05 indicated statistically significant difference.

Results

There were no significant differences in operative time，postoperative drainage volume，drainage tube removal time and average hospital stay between 2 groups（P>0.05）；The complication rate in the modified group was significantly lower than that in the conventional group（6.5% vs. 32.3%，P<0.05），the incision pain score in the modified group was significantly lower than that in the conventional group at 3 d，5 d and 15 d after surgery（P<0.05），and the incision aesthetic satisfaction score was significantly higher than that in the conventional group（P<0.05）. The follow-up period was 4~17 months，no recurrence or metastasis occurred in all patients.

Conclusion

The modified air-free axillary approach in thyroid surgery has the advantages of clear vision，less complications and good cosmetic effect，but the two surgical methods are safe and feasible.

Key words: Thyroidectomy, Laparoscopes, Comparative effectiveness research, Modified non-inflatable axillary approach, Conventional single hole approach for axilla

Zhijie Chen, Cheng Chen, Qiang Li, Aihong Song. Comparative study on clinical effects of two kinds of endoscopic single-port thyroid surgery via axillary approach[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2022, 16(01): 91-94.

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Figures/Tables 5

References 15

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组别	例	年龄（岁）	肿瘤直径（cm）	性别	病理类型
组别	例	年龄（岁）	肿瘤直径（cm）	男/女	A/（a/b）/B
改良组	31	48.2±7.9	3.2±0.6	6/25	7/20/4
常规组	31	48.4±8.1	3.3±0.5	8/23	6/21/4
t/χ²		0.098	0.713	0.369	0.101
P值		0.461	0.239	0.544	0.951

组别	例	年龄（岁）	肿瘤直径（cm）	性别	病理类型
组别	例	年龄（岁）	肿瘤直径（cm）	男/女	A/（a/b）/B
改良组	31	48.2±7.9	3.2±0.6	6/25	7/20/4
常规组	31	48.4±8.1	3.3±0.5	8/23	6/21/4
t/χ²		0.098	0.713	0.369	0.101
P值		0.461	0.239	0.544	0.951

组别	例	手术时间（min）	术中出血量(ml)	术后引流量(ml)	引流管拔除时间（d）	平均住院时间（d）
改良组	31	139.5±45.1	12.2±4.9	45.8±14.2	3.7±0.7	5.7±1.2
常规组	31	130.6±43.2	11.9±4.6	47.4±16.5	3.8±0.6	5.9±1.4
t值		0.793	0.249	0.409	0.713	0.604
P值		0.215	0.402	0.342	0.239	0.274

组别	例	手术时间（min）	术中出血量(ml)	术后引流量(ml)	引流管拔除时间（d）	平均住院时间（d）
改良组	31	139.5±45.1	12.2±4.9	45.8±14.2	3.7±0.7	5.7±1.2
常规组	31	130.6±43.2	11.9±4.6	47.4±16.5	3.8±0.6	5.9±1.4
t值		0.793	0.249	0.409	0.713	0.604
P值		0.215	0.402	0.342	0.239	0.274

组别	例	颅内压升高	高碳酸血症	气体栓塞	皮下气肿	纵隔气肿	呼末CO₂升高	总发生率（%）
改良组	31	1	1	0	0	0	0	2（6.5）
常规组	31	2	3	1	1	2	1	10（32.3）
χ²值								6.613
P值								<0.05

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