|
|
|
| Effects of Trans-Thoracic-Breast Approach Endoscopic Thyroidectomy versus Non-Inflating Trans-Axillary Approach Endoscopic Thyroidectomy on Inflammatory Factors, Endocrine Parameters, and Stress-Related Indicators in Patients with Unilateral Thyroid Cancer |
| LI Yayun, HUA Shenghe, WANG Xincheng, WANG Menglong |
| Department of General Surgery, Shuyang Hospital of Traditional Chinese Medicine, Shuyang Jiangsu 223600 |
|
|
|
|
Abstract 【Objective】 To compare the effects of trans-thoracic-breast approach endoscopic thyroidectomy versus non-inflating trans-axillary approach endoscopic thyroidectomy on inflammatory factors, endocrine parameters, and stress-related indicators in patients with unilateral thyroid cancer. 【Methods】 A total of 110 patients with unilateral thyroid carcinoma admitted to our hospital from January 2022 to January 2025 were selected. According to the surgical approach, they were divided into the control group (55 cases, endoscopic surgery via thoracic-breast approach) and the observation group (55 cases, non-inflating trans-axillary endoscopic surgery). The two groups were compared in terms of surgical indicators (operation time, intraoperative blood loss, number of lymph nodes dissected, postoperative drainage volume), white blood cell (WBC) count, C-reactive protein (CRP), interleukin-6 (IL-6), serum calcium, parathyroid hormone (PTH), cortisol (Cor), adrenaline (Adr), and complications (infection, subcutaneous effusion, transient hoarseness, neck discomfort). 【Results】 Intraoperative blood loss and postoperative drainage volume were lower in the observation group than in the control group (P<0.05). On postoperative day 1, levels of WBC count, CRP, and IL-6 in both groups were higher than their preoperative levels; furthermore, these levels were lower in the observation group than in the control group. The difference were statistically significant (P<0.05). Three days after surgery, there were no significant differences between the two groups in terms of serum calcium, PTH, Cor, and Adr levels (P>0.05). The complication rate in the observation group was 3.64% (2/55), which was lower than the 14.55% (8/55) in the control group (P<0.05). 【Conclusion】 Non-inflating trans-axillary endoscopic radical surgery for thyroid carcinoma is more effective in reducing intraoperative blood loss, alleviating inflammatory response and decreasing complications without increasing risks of endocrine and stress responses.
|
|
Received: 08 September 2025
|
|
|
|
|
|
[1] 何岩,周腼,时通,等. 无充气腋窝入路腔镜甲状腺手术在早期甲状腺肿瘤中的应用效果[J].局解手术学杂志,2025,34(4):329-332.
[2] 邵旭阳,邰小华,曹晨曦. 经口腔前庭入路腔镜手术与开放入路手术对单侧早期甲状腺癌的治疗效果比较[J].蚌埠医科大学学报,2025,50(4):481-485.
[3] 丁鹏,谢方利,刘海科,等. 经腋窝入路无充气腔镜下单侧甲状腺癌根治术治疗效果观察[J].肿瘤研究与临床,2020,32(11):781-785.
[4] 杜宏超,尹明龙,徐龙. 无充气腋窝入路腔镜下甲状腺癌根治术在单侧甲状腺乳头状癌中的疗效[J].中国现代普通外科进展,2024,27(7):558-560.
[5] 马也,孟优,罗雨,等. 无充气经腋窝入路与胸乳入路腔镜手术在单侧甲状腺癌根治术中的应用效果对比[J].中外医学研究,2025,23(17):59-62.
[6] 中国临床肿瘤学会指南工作委员会. 中国临床肿瘤学会(CSCO)分化型甲状腺癌诊疗指南2021[J].肿瘤预防与治疗,2021,34(12):1164-1200.
[7] 元岑玥,李宝元. 经锁骨下入路腔镜与传统开放手术治疗单侧甲状腺乳头状癌的对比研究[J].腹腔镜外科杂志,2025,30(4):241-245.
[8] 刁建华,龚利花,邵志伟,等. 无充气锁骨下入路腔镜甲状腺术与传统开放性手术的疗效比较[J].中国肿瘤外科杂志,2025,17(3):257-260.
[9] 张金金,徐洁,马立,等. 不同入路腔镜甲状腺全切除术治疗甲状腺癌的疗效分析[J].中国现代普通外科进展,2025,28(1):74-77.
[10] 郭朝晖,江豁达,黄彩红,等. 改良型甲状腺手术拉钩支架在充气法经腋窝甲状腺癌根治术中的应用研究[J].中国中西医结合外科杂志,2025,31(1):93-97.
[11] 程娟,任联胜,李彩霞. 经甲状腺内侧气管旁入路行开放性根治术治疗甲状腺癌的效果及对甲状腺功能的影响[J].临床肿瘤学杂志,2025,30(1):65-68.
[12] 凌尧,兰雪君,税羽伽,等. 无充气腋窝入路完全腔镜下甲状腺癌根治术对甲状旁腺功能及相关激素水平的影响分析[J].河北医学,2023,29(7):1192-1196.
[13] 李莉,王建军,曹俊宇,等. 无充气腋窝入路与经胸乳入路腔镜甲状腺癌根治术的效果分析[J].实用医学杂志,2023,39(13):1669-1674.
[14] 那将超,朱江,狄长安. 腋窝入路无充气完全腔镜下甲状腺癌根治术对颈部功能的影响[J].局解手术学杂志,2023,32(3):234-238.
[15] 李亚芸,华胜和,王梦龙,等. 无充气经腋窝入路与胸乳入路腔镜在甲状腺单侧腺叶切除术中的应用效果[J].中国医药导报,2023,20(13):104-107. |
|
|
|
2026, Vol. 43 
