A comparative study of endoscopic thyroidectomy through oral vestibular approach with different methods of space establishment

doi:10.3877/cma.j.issn.1674-3946.2025.01.023.

Abstract

Abstract:

Objective

To compare the effect of transvestibular approach endoscopic thyroid surgery（TOETVA） with different methods of space establishment.

Methods

A total of 120 patients with thyroid disease who received TOETVA treatment from June 2020 to June 2023 were collected as research objects， and the enrolled patients were randomly divided into group A and group B according to random number method，with 60 patients in each group.Surgical space was established in group A by conventional method， and in group B by dilatant liquid-water separation method.Statistical software SPSS 22.0 was used to analyze the data.Measurement data such as perioperative indicators， SSA and VHI scores were expressed by （x ± s）， and independent sample t test was performed.The statistical data of postoperative complications were expressed by［ cases （%）］ and analyzed by χ² test.P＜0.05 indicated that the difference was statistically significant.

Results

The time of lumen formation in group A was significantly lower than that in group B， but the operative time and intraoperative blood loss were significantly higher than those in group B （P＜0.05）.There were no significant differences in drainage tube removal time， postoperative hospitalization time and postoperative aesthetic satisfaction between the two groups （P＞0.05）.The total incidence of complications in group B was slightly lower than that in group A （15.0% vs.23.3%）， but the difference was not statistically significant （P＞0.05）.The VHI-10 score and SSA score of group B were significantly lower than those of group A at 1 week and 1 month after surgery （P＜0.05）.

Conclusion

Although the conventional operation space establishment method has few steps and short time， the dilatation liquid water separation method has a clearer level， can effectively shorten the operation time， reduce intraoperative bleeding， and is more conducive to protecting the function of recurrent laryngeal nerve， and is worthy of clinical promotion.

Key words: Thyroid, Endoscopic Thyroidectomy, Oral Vestibular Approach, Working Place

Weiwei Wang, Jianping Fei, Zhangyu Wang. A comparative study of endoscopic thyroidectomy through oral vestibular approach with different methods of space establishment[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 84-87.

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Figures/Tables 4

组别	例数	性别（例）男/女	年龄（岁， $\overset{ˉ}{x}$ ±s）	体重指数（kg/m²， $\overset{ˉ}{x}$ ±s）
筋膜组	60	20/40	47.9±8.5	22.2±3.1
血管组	60	17/43	49.1±8.9	22.8±3.3
t/χ²值		0.315	0.755	1.026
P值		0.575	0.226	0.153
组别	例数	病灶数量（例）单发/多发	病灶大小（cm， $\overset{ˉ}{x}$ ±s）	病理类型（例）a/b/c
筋膜组	60	51/9	3.4±1.5	35/16/9
血管组	60	48/12	3.6±1.3	37/15/8
t/χ²值		0.519	0.780	0.147
P值		0.471	0.218	0.929

组别	例数	性别（例）男/女	年龄（岁， $\overset{ˉ}{x}$ ±s）	体重指数（kg/m²， $\overset{ˉ}{x}$ ±s）
筋膜组	60	20/40	47.9±8.5	22.2±3.1
血管组	60	17/43	49.1±8.9	22.8±3.3
t/χ²值		0.315	0.755	1.026
P值		0.575	0.226	0.153
组别	例数	病灶数量（例）单发/多发	病灶大小（cm， $\overset{ˉ}{x}$ ±s）	病理类型（例）a/b/c
筋膜组	60	51/9	3.4±1.5	35/16/9
血管组	60	48/12	3.6±1.3	37/15/8
t/χ²值		0.519	0.780	0.147
P值		0.471	0.218	0.929

组别	例数	建腔时间（min）	手术时间（min）	术中出血量（ml）
A组	60	14.4±2.6	125.4±26.8	34.8±16.4
B组	60	19.2±3.5	117.8±21.3	26.1±12.8
t值		8.528	1.765	1.750
P值		0.000	0.040	0.042
组别	例数	引流管拔除时间（d）	术后住院时间（d）	术后美观满意度（分）
A组	60	2.3±0.4	6.3±0.8	9.6±1.3
B组	60	2.2±0.3	6.1±0.7	9.8±1.2
t值		1.549	1.457	0.876
P值		0.062	0.074	0.191

组别	例数	术中并发症		术后并发症		总并发症
组别	例数	喉返神经牵拉损伤	皮肤热灼伤	下唇及颏部麻木	暂时性甲状旁腺功能减退	总并发症
A组	60	4（6.7）	3（5.0）	2（3.3）	5（8.3）	14（23.3）
B组	60	2（3.3）	1（1.7）	2（3.3）	4（6.7）	9（15.0）
χ²值		0.175	0.257	0.259	0.120	1.345
P值		0.675	0.309	0.611	0.729	0.246

组别	例数	VHI-10评分		SSA评分
组别	例数	术后1周	术后1个月	术后1周	术后1个月
A组	60	16.5±2.8	12.5±2.3	24.1±3.4	22.2±2.1
B组	60	15.6±2.5	11.7±2.0	23.0±3.0	21.6±1.8
t值		1.857	2.033	1.879	1.680
P值		0.033	0.022	0.031	0.048

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