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| Comparison of clinical efficacy and safety between endoscopic transareolar approach and open surgery in complex thyroid surgery#br# |
| XU Fangzheng MA Boheng▲ |
| Department of General Surgery, Rugao People’s Hospital, Jiangsu Province, Rugao 226500, China |
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Abstract Objective To compare the clinical efficacy and safety between endoscopic transareolar approach and open surgery in complex thyroid surgery. Methods A total of 83 patients who underwent complex thyroid surgery in Rugao People’s Hospital, Jiangsu Province from January 2018 to May 2021 were selected, and they were divided into study group (endoscopic via areola approach, 43 cases) and control group (open surgery, 40 cases) according to different surgical methods. Surgery time, intraoperative blood loss, and hospital stay were compared between the two groups. The stress response related indexes of the two groups were compared 30 min before surgery, 6 h after surgery, and 12 h after surgery. Visual analogue scale (VAS) and Vancouver scar rating scale (VSS) scores were compared between the two groups. The perioperative complications of the two groups were recorded. Results The amount of intraoperative blood loss in the study group was lower than that in the control group, and the length of hospital stay was shorter than that in the control group, the differences were statistically significant (P ＜ 0.05). There were statistically significant differences in cortisol (Cor), angiotensin Ⅱ (AngⅡ), and adrenaline levels between the two groups at each time point (P ＜ 0.05). The levels of Cor, Ang Ⅱ, and adrenaline in the study group at 6 and 12 h after surgery were lower than those in the control group at the same time point, the differences were statistically significant (P ＜ 0.05). VAS and VSS scores of the study group were lower than those of the control group, and the differences were statistically significant (P ＜ 0.05). The total incidence of perioperative complications in the study group was lower than that in the control group, the difference was statistically significant (P ＜ 0.05). Conclusion Compared with open surgery, endoscopic surgery through areola approach for complex thyroid can guarantee the therapeutic effect and reduce intraoperative blood loss, shorten the length of hospital stay, relieve stress reaction, relieve postoperative pain, improve aesthetic value, and reduce postoperative complications.
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