Clinical observation of transthoracic approach endoscopic surgery for thyroid cancer

doi:10.3877/cma.j.issn.1674-3946.2025.02.023.

Abstract

Abstract:

Objective

To investigate the clinical effect and postoperative complications of transthoracic approach endoscopy and traditional surgery in the treatment of papillary thyroid carcinoma.

Methods

A total of 60 patients diagnosed with papillary thyroid carcinoma admitted from July 2022 to December 2023 were selected and divided into control group and observation group by random number table method, with 30 patients in each group.The control group underwent traditional open surgery, and the observation group underwent transthoracic approach endoscopy.SPSS 20.0 software was used to process the data, and the measurement data were expressed as (± s).Independent sample t test was used for comparison between groups, and repeated measurement ANOVA was used for comparison at different time points.The count data were represented by［ cases (%)］ and χ² test was performed.TNM stage, pathological classification grade data row rank sum test.P＜0.05 was considered statistically significant.

Results

The operation time of observation group was significantly longer than that of control group, the postoperative blood loss was significantly less than that of control group, and the length of surgical incision was significantly shorter than that of control group (P＜0.05).Observation group postoperative pain visual analogue Scale (VAS) score, Vancouver Scar Rating Scale (VSS) score, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), serum free triiodothyronine (FT3), serum free thyroxine (FT4) and serum free thyroxine (FT4) score The incidence of thyroid stimulating hormone (TSH) and complications were significantly lower than those in control group (P＜0.05).

Conclusion

Compared with traditional surgery, transthoracic approach endoscopic surgery for papillary thyroid carcinoma can improve the clinical efficacy and the levels of inflammatory factors and thyroid hormones.

Key words: Thyroid Neoplasms, Carcinoma, Papillary, Thyroidectomy, Transthoracic Laparoscopic Approach

Jian Sun, Minghui Zhao, Enchun Zhao, Weichen Liu. Clinical observation of transthoracic approach endoscopic surgery for thyroid cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(02): 204-207.

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URL: https://zhpwkssxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3946.2025.02.023.

https://zhpwkssxzz.cma-cmc.com.cn/EN/Y2025/V19/I02/204

Figures/Tables 6

组别	例数	性别（例）	年龄（岁， $\overset{ˉ}{x}$ ±s）	肿瘤位置（例）	体质量指数（kg/m²， $\overset{ˉ}{x}$ ±s）
组别	例数	男/女	年龄（岁， $\overset{ˉ}{x}$ ±s）	左/右	体质量指数（kg/m²， $\overset{ˉ}{x}$ ±s）
A组	30	8/22	46.3±6.0	18/12	23.2±1.2
B组	30	9/21	47.0±5.5	16/14	23.1±1.2
χ ²/t值		0.082	0.530	0.271	0.275
P值		0.775	0.597	0.602	0.784

组别	例数	性别（例）	年龄（岁， $\overset{ˉ}{x}$ ±s）	肿瘤位置（例）	体质量指数（kg/m²， $\overset{ˉ}{x}$ ±s）
组别	例数	男/女	年龄（岁， $\overset{ˉ}{x}$ ±s）	左/右	体质量指数（kg/m²， $\overset{ˉ}{x}$ ±s）
A组	30	8/22	46.3±6.0	18/12	23.2±1.2
B组	30	9/21	47.0±5.5	16/14	23.1±1.2
χ ²/t值		0.082	0.530	0.271	0.275
P值		0.775	0.597	0.602	0.784

组别	例数	手术时间（min）	术中出血量（ml）	切口长度(cm)
观察组	30	126.2±25.5	12.9±4.9	5.2±0.5
对照组	30	86.9±12.1	25.5±7.6	8.5±0.8
t值		7.637	7.748	4.238
P值		0.001	0.005	0.023
组别	例数	术后引流量(ml)	住院时间(d)	中央区淋巴结清扫数量（枚）
观察组	30	16.8±5.5	5.3±1.7	7.9±2.0
对照组	30	15.5±5.1	5.7±1.8	8.1±2.3
t值		0.851	0.617	0.506
P值		0.400	0.541	0.615

组别	例数	VAS评分		VSS评分
组别	例数	术前	术后	VSS评分
观察组	30	5.9±1.5	2.0±0.2^a	6.0±1.0
对照组	30	5.9±1.5	2.8±0.2^a	8.4±1.0
t值		0.100	10.602	7.528
P值		0.921	0.004	0.008

组别	例数	时间	CRP(mg/L)	IL-6(ng/L)	TNF-α(ng/L)
观察组	30	术前	20.4±2.1	13.9±2.3	61.3±6.6
观察组	30	术后	7.8±1.0^ab	3.9±1.0^ab	44.5±5.9^ab
对照组	30	术前	21.0±2.4	14.0±2.8	62.0±7.0
对照组	30	术后	13.2±1.2^a	9.2±1.2^a	54.0±4.6^a

组别	例数	时间	FT3(pmol/L)	FT4(pmol/L)	TSH(mIU/L)
观察组	30	术前	4.3±0.4	12.4±1.2	2.1±0.3
观察组	30	术后	2.1±0.2^ab	9.0±1.1^ab	1.0±0.2^ab
对照组	30	术前	4.3±0.4	12.4±1.3	2.2±0.3
对照组	30	术后	3.8±0.3^a	10.2±1.0^a	1.8±0.2^a

组别	例数	切口感染	伤口裂开	声音嘶哑	低钙血症	喝水呛咳	总并发症
研究组	30	0(0.0)	0(0.0)	1(3.3)	0(0.0)	1(3.3)	2(6.7)
对照组	30	1(3.3)	1(3.3)	2(6.7)	0(0.0)	1(3.3)	5(16.7)
χ ²值		-	-	-	-	-	4.007
P值		-	-	-	-	-	0.045

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