Clinical effectiveness of endoscopic surgery using a chest-breast approach for thyroid papillary cancer
Objective To investigate the efficacy of endoscopic surgery using a chest-breast approach for thyroid papillary cancer and its effect on stress response and pain transmitters.Methods A total of 100 patients with thyroid papillary cancer who received treatment at Zhoushan Hospital between January 2022 and January 2023 were retrospectively included in this study.These patients were divided into an endoscopic surgery group and a traditional surgery group according to the surgical method used,with 50 patients in each group.The endoscopic surgery group received endoscopic surgery,while the traditional surgery group underwent traditional open surgery.Surgical indicators,postoperative complications,thyroid function measured before surgery and 5 days after surgery,stress response,and pain transmitters were compared between the two groups.Results The operative time in the endoscopic surgery group was longer than that in the traditional surgery group[(147.84±27.95)minutes vs.(112.31±23.16)minutes,t=6.92,P＜0.001].Intraoperative blood loss in the endoscopic surgery group was less than that in the traditional surgery group[(20.81±4.24)mL vs.(37.74±6.56)mL,t=15.33,P＜0.001].Postoperative drainage amount in the endoscopic surgery group was significantly less than that in the traditional surgery group[(32.34±6.84)mL vs.(47.96±12.31)mL,t=7.84,P＜0.001].Postoperative length of hospital stay in the endoscopic surgery group was significantly shorter than that in the traditional surgery group[(4.06±1.31)days vs.(6.87±1.54)days,t=9.83,P＜0.001).The incidence of postoperative complications in the endoscopic surgery group was significantly lower than that in the traditional surgery group(6.00％vs 20.00％,x2=4.33,P=0.037).At 5 days post-surgery,the levels of triiodothyronine and thyroxine in the endoscopic surgery group were significantly lower than those in the traditional surgery group,while the level of thyroid stimulating hormone was significantly higher(t=5.57,8.69,10.17,all P＜0.001).At 5 days post-surgery,the levels of cortisol and malondialdehyde in the endoscopic surgery group were significantly lower than those in the traditional surgery group(t=9.31,17.21,both P＜0.001).At 5 days post-surgery,the levels of substance P,neuropeptide Y,and prostaglandin E2 in the endoscopic surgery group were significantly lower than those in the traditional surgery group(t=9.84,13.65,10.94,all P＜0.05).Conclusion The endoscopic surgery using a chest-breast approach is highly effective in treating thyroid papillary cancer,with minimal complications.It greatly enhances thyroid function,elicits a low stress response,and effectively suppresses the release of pain transmitters.
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