Clinical study of the medial paratracheal approach in radical surgery for thyroid cancer
Objective To explore the application of medial parathoracic approach to the thyroid gland in open radical thyroid cancer surgery.Methods The clinical data of 180 patients who underwent radical thyroid cancer surgery in the Department of Thyroid Surgery of Henan Provincial People's Hospital from January 2023 to October 2023 were selected.The patients were divided into control group and obser-vation group by the random number table method,in which 90 patients were subjected to the traditional lat-eral thyroid approach(control group),and the other 90 patients were given the medial parathyroidal ap-proach(observation group).The operation time,intraoperative bleeding,postoperative hoarseness and hy-pocalcemia symptoms were compared between the two groups.Postoperative drainage volume,extubation time,postoperative hospitalization days,serum Ca2+and parathyroid hormone(PTH)levels were detected at 1st,3rd,5th,and 30th d postoperatively,respectively.Differences between groups were analyzed by t test,rank sum test and x2 test.Results Intraoperative bleeding and operation time were significantly re-duced in the observation group as compared with the control group[(10±4)ml and(67±8)min in the observation group;(18±5)ml and(95±12)min in the control group,t=-6.687,-3.121,P＜0.05],and one case of hypocalcemic symptoms in the observation group and 8 cases in the control group(x2=5.731,P＜0.05).Serum Ca2+levels at 1st,3rd,5th,30th d postoperatively were(2.23±0.15),(2.25±0.18),(2.24±0.14),(2.28±0.12)mmol/L in the observation group,significantly higher than those in the control group correspondingly[(2.12±0.13),(2.15±0.22),(2.18±0.19),(2.20± 0.15)mmol/L;t=0.243,0.312,0.358,0.406,P＜0.05].Serum PTH level in the observation group was(22.3±6.8),(25.2±5.8),(24.8±6.3),(33.7±5.1)pg/ml respectively,also significantly higher than that in the control group correspondingly[(15.8±5.6),(16.3±7.9),(18.2±8.5),(24.6±7.2)pg/ml;t=2.982,0.284,0.233,0.282,P＜0.05].Conclusion The application of me-dial paratracheal approach to the thyroid gland for radical thyroid cancer surgery is a safe and reliable surgi-cal access with fast operation,clear field,and good protection of the function of the recurrent laryngeal nerve and parathyroid glands.
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