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Clinical study of transthoracic endoscopic thyroid surgery in thyroid surgery / 国际外科学杂志
International Journal of Surgery ; (12): 840-845, 2019.
Article in Chinese | WPRIM | ID: wpr-823538
ABSTRACT
Objective To explore the safety and effectiveness of transthoracic endoscopic thyroid surgery in thyroid surgery.Methods Retrospectively analyzed 230 patients with thyroid tumor aged from 19 to 71 years,including 67 males and 163 females,who were admitted to General minimally invasive surgery,First Affiliated Hospital of Henan University of Chinese Medicine from March 2018 to August 2019.All patients were divided into traditional operation group (n =95) and endoscopic group (n =135) according to the operation method.The general information of the two groups of patients before surgery,including the time of surgery and tumor removal,amount of bleeding during surgery,postoperative drainage and extubation time,were compared.And the hospital stay,hoarseness,postoperative bleeding,incision infection,numbness,twitching,satisfaction and other related indicators were calculated also.SPSS 22.0 software was used for statistical analysis.Normally distributed measurement data were expressed as Mean ± SD,and conparisons between groups were calculated by t test or x2 test.The non-normally distributed data were expressed as M(P25,P75) and were analyzed by the Mann-Whitney U test.Results Compared with the preoperative general data,the number of nodules in the traditional group was 3.00 (2.00,3.00),and the number of nodules in the endoscope group was 2.00 (1.00,3.00).The difference was statistically significant (Z =-4.461,P < 0.01).The maximum diameter of the tumor in the traditional group is 1.00 (1.00,2.00) cm,and the maximum diameter of the tumor in the endoscope group is 1.00 (1.00,2.00) cm.The two are statistically significant (Z =-2.041,P =0.041).There were no significant differences in age,gender,course of disease,nodule type,cystic change,nodule location,aspect ratio,nodule echo,nodular morphology,and nodular calcification (all P > 0.05).Comparison of intraoperative indicators,the operation time of the traditional group was shorter than that of the endoscope group [(67.51 ± 9.27) min vs (89.86 ± 10.32) min,t =11.462,P < 0.01];the tumor removal time of the traditional group was also shorter than that of the endoscope group [(28.37 ± 8.94) min vs (33.35 ± 7.39) min,t =5.456,P <0.01];the blood loss in the traditional group was significantly more than that in the endoscope group [(51.34 ± 3.26) ml vs (20.65 ± 5.89) ml,t =14.723,P <0.01].The recurrent laryngeal nerve was explored intraoperatively in both groups with a detection rate of 100%,the anesthesia was good in both groups,and the drainage tubes were indwelling in both groups.The drainage volume of the traditional group was significantly higher than that of the endoscope group [(135.76 ± 60.55) ml vs (69.12 ± 37.13) ml,t =10.805,P <0.01].The extubation time was longer in the traditional group than in the endoscope group [(5.54 ± 1.44) d vs (4.66 ± 1.55) d,t =2.384,P=0.023].In terms of hospitalization time,the traditional group was significantly longer than the endoscope group [(10.48 ± 5.37) d vs (7.25 ± 3.68) d,t =11.549,P < 0.01].There were 11 cases of hoarseness in the traditional group and 4 cases of hoarseness in the endoscope group,and there has statistically significant (x2 =6.790,P =0.009).There were 5 cases of postoperative bleeding in the traditional group,1 case of postoperative bleeding in the endoscope group,the difference between the two was statistically significant (x2 =4.365,P =0.037);5 cases of incision infection in the traditional group,none in the endoscope group,and the difference was statistically significant (P =0.012);4 cases of numbness convulsions in the traditional group,none in the endoscope group,and there was statistical significance (P =0.028);87 cases of satisfaction in the traditional group,and 134 cases of satisfaction in the endoscope group,and the difference was statistically significant (x2 =6.825,P =0.009).Conclusions Transthoracic endoscopic thyroid surgery has fewer complications in thyroid surgery and quicker postoperative recovery.It is worthy of widespread promotion,but the specific implementation plan needs to be further optimized.

Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: International Journal of Surgery Year: 2019 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: International Journal of Surgery Year: 2019 Type: Article