Endoscopic surgery via oral vestibular approach in the treatment of cT1N0 stage thyroid cancer:Efficacy and analysis of postoperative recurrence factors
ZHANG Jiaqi
LI Yan
Abstract：Objective This study aimed to explore the therapeutic effects and factors associated with postoperative recurrence in the treatment of cT1N0 stage thyroid cancer using endoscopic surgery via oral vestibular approach.Methods Sixty-five patients with cT1N0 stage thyroid cancer who underwent surgery in the Department of Thyroid and Breast Surgery atPuren Hospital Affiliated to Wuhan University of Science and Technology from March 2018 to March 2020 were selected as the subjects of the study.By using a random number table method,they were divided into a control group(n=32)and an observation group(n=33).The control group underwent traditional open thyroid cancer surgery,and the observation group underwent endoscopic surgery via oral vestibular approach.The surgical conditions(surgical duration,intraoperative blood loss,number of central lymph node dissections,postoperative drainage volume,time for the neck to regain movement),pain levels on day 1,3,and 5 after surgery(using the Visual Analogue Scale(VAS)),levels of inflammation before and 24 hours after surgery(White Blood Cell count(WBC),Tumor Necrosis Factor-alpha(TNF-α),C-Reactive Protein(CRP)),and the condition of the surgical incision at thesecond and fifth months after surgery(using the Vancouver Scar Scale(VSS)and the Observer Scar Assessment Scale(OSAS))were compared between the two groups.Factors that contributed to postoperative recurrence were also analyzed.Results There were no significant differences in the baseline data between the two groups(P＞0.05).Regarding the surgical conditions,the observation group showed less intraoperative blood loss,less postoperative drainage volume,and shorter time for the neck to regain movement than the control group(P＜0.05).The observation group also had lower VAS scores at different postoperative time points compared to the control group(P＜0.05).For the level of inflammation 24 hours after the surgery,the observation group showed lower levels of WBC,TNF-α,and CRP(P＜0.05).In terms of incision recovery,the observation group had lower scores on the VSS and OSAS at the second and fifth months post-surgery(P＜0.05).Cox multivariate regression analysis indicated that tumor diameters of 1.1～2.0 mm,multifocal lesions,positive surgical margins,and the absence of postoperative radiochemotherapy were risk factors for postoperative recurrence of thyroid cancer.Conclusions Endoscopic surgery via oral vestibular approach for the treatment of cT1N0 stage thyroid cancer can effectively reduce the rate of postoperative recurrence,decrease complications,and improve the recovery of thyroid function and quality of life for patients.Tumor diameters of 1.1～2.0 mm,multifocal lesions,positive surgical margins,and the absence of postoperative radiochemotherapy are identified as risk factors for postoperative recurrence of thyroid cancer.
Keywords：Thyroid cancerEndoscopic surgery via oral vestibular approachRecurrence factorsEfficacy
Publication Date：2024-04-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 126-131 )