Gland surgery · 2026
Efficacy of transoral vestibular endoscopic thyroidectomy versus open surgery in the treatment of unilateral thyroid malignancies.
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Yang Haitao, Peng Hong, Li Zhiwei, Ma Xiaoquan
Аннотация
BACKGROUND: Endoscopic surgery has become an increasingly valuable option for patients requiring surgical intervention for unilateral thyroid malignant tumors. This study aimed to compare the efficacy of endoscopic surgery and open surgery in the treatment of unilateral thyroid malignancies.
METHODS: This multicenter retrospective study included 184 patients with unilateral thyroid tumors treated between January 2021 and June 2024 at two tertiary hospitals. All patients were allocated into 2 groups with 1:2 propensity score matching (PSM) using baseline data: one undergoing endoscopic surgery (n=35) and the other undergoing traditional open surgery (n=70). We compared perioperative and postoperative conditions, focusing on parameters such as serum indexes, perioperative surgical indexes, pain visual analogue scale (VAS) scores, Vancouver Scar Scale (VSS) scores, cosmetic satisfaction and incidence of postoperative complications.
RESULTS: Several potential benefits of endoscopic surgery over open surgery were noted, including reduced postoperative inflammatory response, lower blood loss and drainage volume, shorter hospital stay, and better postoperative neck pain control and cosmetic satisfaction (all P<0.05). Additionally, the incidence of postoperative complications in the endoscopic surgery group was significantly lower than that in the open surgery group (11.6% vs. 40.0%, P=0.003). The recurrence rate of the endoscopic surgery group was 8.57% (3/35), while the recurrence rate of the open surgery group was 7.14% (5/70). There was no statistically significant difference in recurrence rates between the two groups of patients (P<0.05).
CONCLUSIONS: For patients with unilateral thyroid malignancies, endoscopic surgery via the transoral vestibular approach, adhering to the principle of oncologic resection equivalent to open surgery, demonstrated advantages in terms of reduced postoperative inflammatory response, less intraoperative blood loss and postoperative drainage, shorter hospital stay, better postoperative pain control, superior cosmetic outcomes, and lower short-term complication rates compared to open surgery.
METHODS: This multicenter retrospective study included 184 patients with unilateral thyroid tumors treated between January 2021 and June 2024 at two tertiary hospitals. All patients were allocated into 2 groups with 1:2 propensity score matching (PSM) using baseline data: one undergoing endoscopic surgery (n=35) and the other undergoing traditional open surgery (n=70). We compared perioperative and postoperative conditions, focusing on parameters such as serum indexes, perioperative surgical indexes, pain visual analogue scale (VAS) scores, Vancouver Scar Scale (VSS) scores, cosmetic satisfaction and incidence of postoperative complications.
RESULTS: Several potential benefits of endoscopic surgery over open surgery were noted, including reduced postoperative inflammatory response, lower blood loss and drainage volume, shorter hospital stay, and better postoperative neck pain control and cosmetic satisfaction (all P<0.05). Additionally, the incidence of postoperative complications in the endoscopic surgery group was significantly lower than that in the open surgery group (11.6% vs. 40.0%, P=0.003). The recurrence rate of the endoscopic surgery group was 8.57% (3/35), while the recurrence rate of the open surgery group was 7.14% (5/70). There was no statistically significant difference in recurrence rates between the two groups of patients (P<0.05).
CONCLUSIONS: For patients with unilateral thyroid malignancies, endoscopic surgery via the transoral vestibular approach, adhering to the principle of oncologic resection equivalent to open surgery, demonstrated advantages in terms of reduced postoperative inflammatory response, less intraoperative blood loss and postoperative drainage, shorter hospital stay, better postoperative pain control, superior cosmetic outcomes, and lower short-term complication rates compared to open surgery.