Comparing the effects of endoscopic surgery via the oral vestibule and thoracic breast approaches on pa-tients with thyroid papilloma

ZHANG Huichao; ZHAO Haibin; ZAI Kaipeng

Abstract：Objective:To compare the efficacy of transoral endoscopic vestibular approach(TOETVA)and endo-scopic thoracic breast approach(ETCBA)in the treatment of patients with papillary thyroid carcinoma(PTC).Meth-ods:A total of 88 patients with PTC in puyang hospital of traditional chinese medicine from January 2021 to March 2024 were selected,and they were randomly divided into observation group and control group using a random number table method.Patients in the observation group were treated with TOETVA,while patients in the control group were treated with ETCBA.The perioperative related indexes,pain degree,scar aesthetics,stress response level and complica-tion rate were compared between the two groups.Results:The number of central lymph node dissection in the observa-tion group was more than that in the control group,the postoperative drainage and blood loss were less than those in the control group,and the operation time was longer than that in the control group,with statistical significance(P＜0.05).The visual analogue scale(VAS)in the observation group was lower than that in the control group on the 1st,3rd and 7th day after operation,with statistical significance(P＜0.05).The vancouver scar scale(VSS)scores in the observa-tion group were lower than those in the control group at 1 month,2 months and 3 months after operation,with statisti-cal significance(P＜0.05).The serum serum norepinehrine(NE),adrenaline(E)and cortisol(Cor)levels in observation group were higher than control group,but with no significant difference(P＞0.05).There was no significant difference in the incidence of complications between the two groups(P＞0.05).Conclusion:There is no significant difference be-tween TOETVA and ETCBA in the treatment of PTC patients in terms of surgical safety and stress response to the body,but TOETVA can reduce pain,improve scar aesthetics,increase the number of central lymph node dissection,re-duce postoperative drainage and intraoperative blood loss,and ETCBA is more helpful to shorten the operation time.