Comparison of clinical efficacy between anterior cervical micro-incision endoscopic surgery and complete areolar ap-proach endoscopic thyroidectomy for differentiated thyroid cancer
Yue Sen
Xing Chaohui
Xu Zhi
Xu Shuwen
Wan Jin
Abstract：Objective To compare the clinical efficacy of anterior cervical micro-incision endoscopic surgery and complete areolar approach endoscopic thyroidectomy in treating differentiated thyroid cancer.Methods From February 2022 to February 2023,Clinical data of 102 patients with differentiated thyroid cancer diagnosed and treated by Head and Neck Sur-gery in Xuzhou Cancer Hospital were collected.They were assigned into anterior cervical group and complete areolar approach group complying with surgical methods,with 51 patients in each group.The anterior cervical group underwent ante-rior cervical micro-incision endoscopic surgery,while the complete areolar approach group underwent complete areolar ap-proach endoscopic thyroidectomy.Two groups were compared for surgical indicators,trauma stress indicators,coagulation function,thyroid function,pain level,complications,and cosmetic satisfaction.Results The anterior cervical group had unu-sually larger number of lymph node dissection(t/P=2.589/0.011),longer surgical time(t/P=2.265/0.026),and less intraoper-ative blood loss than complete areolar approach group(t/P=2.617/0.010).The C-reactive protein(CRP),prostaglandin E2(PGE2),and cortisol(Cor)in both groups unusually increased after surgery(anterior cervical group:t/P=37.105/＜0.001,40.582/＜0.001,37.955/＜0.001;complete areolar approach group:t/P=39.336/＜0.001,43.655/＜0.001,36.791/＜0.001).The postoperative activated partial thromboplastin time(APTT)and prothrombin time(PT)of both groups were prominently short-ened,while fibrinogen(FIB)was prominently increased(anterior cervical group:t/P=7.671/0.014,20.546/＜0.001,4.447/0.021;complete areolar approach group:t/P=13.323/＜0.001,23.695/＜0.001,14.533/＜0.001).The postoperative triiodothyro-nine(T3),thyroxine(T4),free triiodothyronine(FT3),and free thyroxine(FT4)in both groups reduced unusually,while thy-roid stimulating hormone(TSH)raised higher(anterior cervical group:t/P=96.024/＜0.001,27.446/＜0.001,64.267/＜0.001,54.574/＜0.001,30.796/＜0.001;complete areolar approach group:t/P=42.866/＜0.001,26.519/＜0.001,60.782/＜0.001,57.527/＜0.001,34.083/＜0.001).The pain in both groups on postoperative day 2rd was unusually milder than on postoperative 1st day(anterior cervical group:t/P=32.582/＜0.001;complete areolar approach group:t/P=32.566/＜0.001).The total incidence of postoperative complications was not unusually different between the two groups(P＞0.05).The anterior cervical group had prominently lower Vancouver Scar Scale(VSS)score and Patient And Observer Scar Assessment Scale(POSAS)score than complete areolar approach group one year after surgery(t/P=16.964/＜0.001,9.023/＜0.001).Conclusion The clinical efficacy of anterior cervical micro-incision endoscopic surgery is comparable to that of complete areolar approach endoscopic thyroid-ectomy for differentiated thyroid cancer.However,anterior cervical micro-incision endoscopic surgery has more lymph node dissection,longer operation time,less intraoperative bleeding,and higher aesthetic satisfaction.
Keywords：Differentiated thyroid cancerAnterior cervical micro-incision endoscopic surgeryComplete areolar ap-proach endoscopic thyroidectomyEfficacy
Publication Date：2025-06-18
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 717-721,733 )