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Objective To investigate the safety and feasibility of modified gasless trans-subclavian approach endoscopic total thyroidectomy for papillary thyroid carcinoma(PTC).Methods We retrospectively analyzed the clinical data of consecutive 82 patients with PTC who underwent the modified gasless trans-subclavian approach endoscopic total thyroidectomy in the Department of Head and Neck Surgery,Sir Run Run Shaw Hospital,Affiliated with the Zhejiang University School of Medicine,from March 2022 to June 2023.Results All operations were successfully completed under endoscopy approach without transfer to open surgery.The maximum diameter of PTC was(6.6±5.4)mm.The operation duration was(156.5±32.7)min,and the number of lymph nodes in the central compartment was(12.3±6.4).The postoperative hospital stay was(3.3±1.2)d.Postoperative complications included two cases of transient hypoparathyroidism and six cases of transient recurrent laryngeal nerve injury.All the patients recovered in one month.One case of postoperative bleeding was observed.No permanent laryngeal nerve injury,permanent hypoparathyroidism or incision infection occurred.Conclusion The gasless trans-subclavian approach endoscopic total thyroidectomy is a feasible and safety approach in selected PTC patients.The lymph nodes in the central compartment are thoroughly dissected.This approach has obvious advantages in functional protection of the anterior cervical region,and has clinical application value.
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Objective:To study the safety and feasibility of gasless transoral endoscopic thyroidectomy though vestibular approach using self-retaining retractor for papillary thyroid carcinoma.Methods:The clinical data of 39 papillary thyroid carcinoma patients undergoing gasless transoral endoscopic thyroidectomy were collected at Department of Head and Neck Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from Nov 2020 to Jun 2021.Results:All cases successfully underwent laparoscopic surgery without conversion to open surgery. The mean duration of operation was (142±35) min, and the postoperative mean hospital stay was (4.1±0.8) days. The mean maximum diameter of the tumor was (8.5±4.5) mm, and the mean number of lymph node harvest of by central compartment dissection was 7.7±5.9. Postoperative complications were transient hypoparathyroidism in 2 cases but recovered in 1 month. Scalp hydrop in 1 patient,fading subsequently. Transient sensory change around the lower lip in 3 cases, which recovered in 6 months. No patient suffered from recurrent laryngeal nerve palsy or hematoma, no permanent hypoparathyroidism occurred, nor of the postoperative bleeding .Conclusion:The gasless transoral endoscopic thyroidectomy viaoral vestibular approach is a feasible approach in selected papillary thyroid carcinoma patients.
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Objective To investigate the protective effects of Codonopsis lanceolata saponin (CLS) on hepatic ischemia-reperfusion injury (HIRI) and its mechanism in rats.Methods The rats were divided randomly into 3 groups:sham-operated (SO) group, HIRI group and CLS group.HIRI model was made by Pringle method.CLS group was pretreated with CLS (200 mg · kg-1 · d-1) by intragastric administration for 7 days before operation, while SO group and HIRI group were given with distilled water 10 ml · kg-1 · d-1 for 7 days.ALT, AST, SOD, MDA in serum, and SOD and MDA in hepatic tissue were detected by colorimetric method.IL-18 in serum and hepatic tissue was detected by ELISA.Results The levels of serum ALT, AST, MDA, IL-18, TNF-α and tissue MDA, IL-18 in HIRI group were significantly higher than those in SO group and CLS group (all P < 0.05), respectively.The serum and hepatic tissue SOD activity in HIRI group was significantly lower than that in SO group and CLS group (all P < 0.05).Histological observation revealed that the obvious cell necrotic foci with a large number of inflammatory cells infiltration in the HIRI group, while the lesion was obviously alleviated in CLS group.Conclusions Codonopsis lanceolata saponin preconditioning alleviates hepatic ischemia/reperfusion injury.The mechanism may be correlated with inhibiting inflammatory factors and enhancing anti-oxidation.