Effect of open radical resection by medial thyroid tracheal approach for thyroid cancer and its effect on thyroid function

CHENG Juan; REN Liansheng; LI Caixia

doi:10.3969/j.issn.1009-0460.2025.01.012

Abstract：Objective To explore the effect of open radical surgery via the medial paratracheal approach within the thyroid gland for thyroid cancer and its influence on thyroid function.Methods A total of 72 patients with thyroid cancer from March 2021 to March 2024 were selected,and further divided into the bypass group(n=39,using the medial thyroid tracheal approach)and the traditional group(n=33,using the traditional lateral thyroid approach).The thyroid function index(T3,T4,TSH),serum Ca2+and thyroid hormone(PTH)level,stress hormone(NE,Cor,SOD)levels and inflammatory factors(white blood cell,C reactive protein)level were compared between the two groups.The occurrence of postoperative complications were recorded.Results The operation time and intraoperative bleeding volume in the bypass group were significantly better than those in the traditional group(P<0.05).However,indicators such as total drainage rate,postoperative extubation time and hospitalization days were not significant between the two groups(P>0.05).Three days after surgery,the levels of T3 and T4 in the both two groups decreased compared to preoperative levels,while TSH levels increased.The bypass group was superior to the traditional group(P<0.05).Three days after surgery,the serum Ca2+and PTH levels in the both two groups decreased,and the indicators in the bypass group was higher than those in the traditional group(P<0.05);Three days after surgery,the serum levels of NE and Cor in the both two groups increased compared to preoperative levels,while the level of SOD decreased.The bypass group was significantly better than the traditional group(P<0.05);Three days after surgery,the levels of white blood cells and C reactive protein in the both two groups increased compared to preoperative levels,and the bypass group was lower than those in the traditional group(P<0.05).The incidence of postoperative complications in the bypass group was 7.7%,which was not significantly different from 15.2%of the traditional group(P=0.531).Conclusion Open radical surgery via the medial paratracheal approach within the thyroid gland for thyroid cancer can significantly shorten the operation time,reduce the amount of intraoperative bleeding,the damage of thyroid function and parathyroid function,and the inflammatory response of patients'postoperative stress.