Posterior sternocleidomastoid border approach of gasless transaxillary endoscopic thyroidectomy in patients with papillary thyroid carcinoma: comparison with sternocleidomastoid fascia approach
Zhou Yuqiu, Li Chao, Cai Yongcong, Jiang Jian, Sun Ronghao, Zeng Dingfen, Zheng Wanghu, Wang Wei
Abstract
ObjectiveTo examine the posterior sternocleidomastoid border approach which elevated whole sternocleidomastoid in gasless transaxillary endoscopic thyroidectomy.
MethodsThe clinical data of 46 patients with papillary thyroid carcinoma treated with gasless transaxillary endoscopic thyroidectomy from May 2019 to June 2020 at Department of Head and Neck Surgery, Sichuan Cancer Hospital was analyzed retrospectively. There were 9 males and 37 females, aged (38.6±12.0) years (range: 19 to 74 years). Fourteen and 32 cases performed posterior sternocleidomastoid border and sternocleidomastoid fascia approach, respectively. Comparative analysis were performed on clinical characters, surgical outcomes, postoperative complications, postoperative pain score, and quality-of-life of postoperative 1 month by t test, Wilcoxon rank sum test, Fisher exact test and χ2 test,respectively. Resuts Complete exposure of central compartment was higher (11/14 vs. 34.4%(11/32),χ²=7.624, P=0.006), more lymph nodes was retrieved (4.2±2.9 vs. 2.0±2.5, t=2.663, P=0.011) in posterior sternocleidomastoid border approach. There were no significant differences between groups in postoperative complications such as recurrent laryngeal nerve palsy (1/14 vs. 3.1%(1/32), P=0.521) and transient hypoparathyroidism (0 vs. 6.2%(2/32), P=1) and pains and quality-of-life.
ConclusionPosterior sternocleidomastoid border approach of gasless transaxillary endoscopic thyroidectomy is safe and reliable and has the advantage of central compartment dissection without increasing trauma.
Key words:
Thyroid neoplasms; Thyroidectomy; Laparoscopy
Contributor Information
Zhou Yuqiu
Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Cancer Research Institute, Sichuan Cancer Prevention and Cure Center, Cancer Hospital Affiliate to School of Medicine, Electronic Science and Technology, Chengdu 610041, China
Li Chao
Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Cancer Research Institute, Sichuan Cancer Prevention and Cure Center, Cancer Hospital Affiliate to School of Medicine, Electronic Science and Technology, Chengdu 610041, China
Cai Yongcong
Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Cancer Research Institute, Sichuan Cancer Prevention and Cure Center, Cancer Hospital Affiliate to School of Medicine, Electronic Science and Technology, Chengdu 610041, China
Jiang Jian
Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Cancer Research Institute, Sichuan Cancer Prevention and Cure Center, Cancer Hospital Affiliate to School of Medicine, Electronic Science and Technology, Chengdu 610041, China
Sun Ronghao
Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Cancer Research Institute, Sichuan Cancer Prevention and Cure Center, Cancer Hospital Affiliate to School of Medicine, Electronic Science and Technology, Chengdu 610041, China
Zeng Dingfen
Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Cancer Research Institute, Sichuan Cancer Prevention and Cure Center, Cancer Hospital Affiliate to School of Medicine, Electronic Science and Technology, Chengdu 610041, China
Zheng Wanghu
Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Cancer Research Institute, Sichuan Cancer Prevention and Cure Center, Cancer Hospital Affiliate to School of Medicine, Electronic Science and Technology, Chengdu 610041, China
Wang Wei
Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Cancer Research Institute, Sichuan Cancer Prevention and Cure Center, Cancer Hospital Affiliate to School of Medicine, Electronic Science and Technology, Chengdu 610041, China