Original Article
Comparison of clinical effects of endoscopic thyroidectomy using the modified gasless transsubclavian approach and traditional open surgery for cN0 unilateral papillary thyroid carcinoma
Xuemei Zhu, Haitao Wang, Shuai Xue, Haowen Xue, Qiyu Lu, Guang Chen, Peisong Wang
Published 2023-09-01
Cite as Chin J Surg, 2023, 61(9): 807-811. DOI: 10.3760/cma.j.cn112139-20230208-00056
Abstract
ObjectiveTo compare the clinical effects of endoscopic thyroidectomy using a modified gasless transsubclavian approach and the traditional neck approach for unilateral papillary thyroid carcinoma (cN0).
MethodsThe clinical data of 135 patients with cN0 papillary thyroid carcinoma who underwent unilateral thyroidectomy in the Department of Thyroid Surgery, the First Hospital of Jilin University from October 2020 to November 2022 were retrospectively analyzed. There were 37 males and 98 females, aging (43.2±8.8) years (range: 21 to 59 years). There were 51 cases using the modified gasless transsubclavian approach (TS group) and 84 cases using the traditional neck approach (TN group). Comparative analyses were performed between the operative results of the 2 groups by t-test, Wilcoxon rank sum test, and χ2 test.
ResultsAll endoscopic operations were successfully completed without conversion to the traditional neck approach. Compared to the TN group, the TS group had a longer operation time (M(IQR)) (73.5 (22.5) minutes vs. 90.0 (30.0) minutes, Z=-5.831, P<0.01), more postoperative drainage (60 (25) ml vs. 95 (45) ml, Z=-6.275, P<0.01), higher hospitalization costs (22 687 (3 488) yuan vs. 26 652 (2 431) yuan, Z=-6.944, P<0.01), and a higher rate of parathyroid autotransplantation (15.5% (13/84) vs. 60.8% (31/51), χ2=29.651, P<0.01). There was no significant difference in the total exposure rate of the central compartment, postoperative hospitalization time, the number of dissected lymph nodes, the number of metastatic lymph nodes, C-reactive protein ratio before and after operation, and preoperative and postoperative parathyroid hormone (all P>0.05).
ConclusionEndoscopic thyroidectomy using the modified gasless transsubclavian approach is safe for cN0 papillary thyroid carcinoma, with longer operating time, more postoperative drainage, higher hospitalization costs, and more difficulty in preserving the inferior parathyroid gland in situ compared to traditional open surgery.
Key words:
Thyroid neoplasms; Thyroidectomy; Transsubclavian approach; Modified gasless endoscopic thyroidectomy; Papillary thyroid carcinoma
Contributor Information
Xuemei Zhu
Department of Thyroid Surgery, General Surgery Center, the First Hospital of Jilin University, Changchun 130021, China
Haitao Wang
Department of Critical Care Medcine, the First Hospital of Jilin University, Changchun 130021, China
Shuai Xue
Department of Thyroid Surgery, General Surgery Center, the First Hospital of Jilin University, Changchun 130021, China
Haowen Xue
Department of Thyroid Surgery, General Surgery Center, the First Hospital of Jilin University, Changchun 130021, China
Qiyu Lu
Department of Thyroid Surgery, General Surgery Center, the First Hospital of Jilin University, Changchun 130021, China
Guang Chen
Department of Thyroid Surgery, General Surgery Center, the First Hospital of Jilin University, Changchun 130021, China
Peisong Wang
Department of Thyroid Surgery, General Surgery Center, the First Hospital of Jilin University, Changchun 130021, China
