[Effectiveness of transoral endoscopic thyroid surgery for lymph node dissection in the central region of thyroid cancer].

Objective

To investigate the effect of transoral endoscopic thyroid surgery in the central lymph node dissection of thyroid cancer.

Methods

Twenty patients underwent endoscopic thyroidectomy via oral vestibular approach （TOETVA group） and 20 gender and age matched patients underwent conventional open thyroidectomy were selected in this study. The clinical data, number of lymph node dissection and postoperative complications of the two groups were collected and analyzed. SPSS 24.0 statistical software was used for data analysis.

Results

There was no significant differences in age, BMI, tumor size or the number of Hashimoto's thyroiditis patients between the TOETVA group and the open group（P>0.05）. The operation time（[117.30±10.54]min） and postoperative drainage volume（[146.05±30.66]mL） in the TOETVA group were significantly higher than those in the open group（[59.05±6.40]min, [77.90±22.18]mL）, P<0.001. The pain in the open group 24 h after surgery was more severe than that in the TOETVA group（P<0.05）. The total number of central lymph nodes, the number of pre-laryngeal lymph nodes and the number of pre-tracheal lymph nodes cleared by the two groups were similar, and the number of final positive lymph nodes had no significant difference. However, the number of paratracheal lymph nodes removed in the TOETVA group was more（7.8±4.2） nodes than that in the open group（6.4±3.9） nodes, P<0.05. There was no significant difference in postoperative complications between the two groups. The scores of cosmetic evaluation and rating of cicatrices in the TOETVA group six months after surgery were（0.77±0.58） significantly lower than those in the open group（4.30±1.54）, P<0.001.

Conclusion

In central lymph node dissection, the efficiency of TOETVA is similar to that of traditional open thyroid surgery. For special anatomical regions, endoscopic surgery is more efficient. At the same time, TOETVA does not increase the incidence of related complications, and has good cosmetic effect.