A single-centre retrospective study of gasless trans-subclavian endoscopic total thyroidectomy for papillary thyroid carcinoma
Objective:To investigate the short-term efficacy of gasless trans-subclavian endoscopic total thyroidectomy for papillary thyroid carcinoma.Methods:From Dec.2022 to Dec.2023,the clinical data of patients who underwent gasless trans-subclavian endoscopic total thyroidectomy combined with central lymph node dissection(endoscopic group)and patients who underwent conven-tional total thyroidectomy combined with central lymph node dissection(open group)in the same period were retrospectively analyzed.Results:A total of 137 patients were enrolled,including 37 cases in the endoscopic group and 100 cases in the open group.The average age of the endoscopic group was younger than that of the open group[(44.24±8.44)years vs.(49.08±10.82)years],and the opera-tion time was longer than that of the open group[(106.89±21.90)min vs.(79.88±21.76)min].The volume of postoperative drain-age in the endoscopic group were more than those in the open group[(107.62±31.16)mL vs.(82.04±31.68)mL].The cosmetic satisfaction in the endoscopic group was higher than that in the open group[3(2-3)vs.2(1-3)],and the incidence of neck discomfort in the endoscopic group was lower than that in the open group[7(18.9%)vs.43(43.0%)],with statistically significant differences(P<0.05).There were no significant differences between the two groups in gender,BMI,tumor diameter,Hashimoto's thyroiditis,T stage,intraoperative blood loss,the number of retrieved central lymph nodes,number of metastatic central lymph nodes,time of postope-rative drainage,and postoperative thyroglobulin level(P>0.05).In addition,there were no significant differences in incidence of tem-porary and permanent hypoparathyroidism,temporary and permanent recurrent laryngeal nerve injury,hematoma between the two groups(P>0.05).and no lymphatic leakage,incision infection,tracheal injury,and esophageal injury occurred Conclusions:Gasless trans-subclavian endoscopic total thyroidectomy combined with central lymph node dissection is a safe and effective surgical method for papil-lary thyroid carcinoma.Its cosmetic effect and postoperative neck comfort are better than those of traditional open thyroidectomy.
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