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How Should the Surgical Approach In Thyroidectomy Be Selected? A Prospective Study Comparing the Trauma of 3 Different Thyroidectomy Surgical Approaches.
Jian, Chen-Xing; Wu, Li-Min; Zheng, Zi-Fang; Liu, Wei; Fang, Jian-Ying; Tu, Hai-Jian.
Afiliação
  • Jian CX; Departments of Minimally Invasive Surgery.
  • Wu LM; Departments of Minimally Invasive Surgery.
  • Zheng ZF; Departments of Minimally Invasive Surgery.
  • Liu W; Departments of Minimally Invasive Surgery.
  • Fang JY; Medicine.
  • Tu HJ; Clinical Laboratory, Affiliated Hospital of Putian University, Putian, Fujian Province, China.
Surg Laparosc Endosc Percutan Tech ; 30(1): 22-25, 2020 Feb.
Article em En | MEDLINE | ID: mdl-31855923
OBJECTIVE: To compare the trauma of 3 different surgical approaches and provide a reference for clinicians in choosing the operative procedure. PATIENTS AND METHODS: A total of 150 patients were divided into the total endoscopic thyroidectomy (TET), endoscopic-assisted thyroidectomy (EAT), and conventional open thyroidectomy (COT) groups, with 50 patients in each group. The peripheral blood C-reactive protein (CRP) levels at different postoperative time points, operative time, intraoperative blood loss, postoperative drainage volume, postoperative pain, degree of satisfaction with the incision appearance, postoperative extubation time, and swallowing discomfort 3 months after surgery were compared among the groups that received different surgical approaches. RESULTS: The operative time of TET was longer than that of COT and EAT. The intraoperative blood loss was significantly lower in the TET and EAT groups than in the COT group. The postoperative drainage volume was lowest after EAT and highest after TET. The extubation time was significantly shorter after EAT than after TET and COT. The 6-hour CRP level was significantly higher after TET than after EAT and COT, and the 24-hour CRP level was better in the EAT group than in the other 2 groups. The CRP levels at 72 hours postoperatively were lowest in the EAT group and highest in the TET group. Postoperative pain was significantly lower after EAT than after TET and COT. Cosmetic satisfaction was highest in the TET group and lowest in the COT group. Swallowing discomfort was lowest in the EAT group and highest in the TET group. There was a positive correlation between the drainage volume on the first postoperative day, the drainage tube removal time, dysphagia, and the CRP level in each period. There was a positive correlation between pain, cosmetic satisfaction and CRP in 2 of the time periods. CONCLUSIONS: All 3 types of thyroidectomy are safe and reliable in benign tumor resection. Therefore, in clinical practice, the age, sex, and cosmetic needs of the patients, and the oncological safety should all be considered to provide patients with the most appropriate recommendations. In view of oncological safety, TET should be carefully selected for malignant tumor resection.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Dor Pós-Operatória / Tireoidectomia / Perda Sanguínea Cirúrgica / Nódulo da Glândula Tireoide / Endoscopia Tipo de estudo: Guideline / Observational_studies / Prognostic_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Surg Laparosc Endosc Percutan Tech Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Dor Pós-Operatória / Tireoidectomia / Perda Sanguínea Cirúrgica / Nódulo da Glândula Tireoide / Endoscopia Tipo de estudo: Guideline / Observational_studies / Prognostic_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Surg Laparosc Endosc Percutan Tech Ano de publicação: 2020 Tipo de documento: Article