Comparison of Application Effects of Non-inflatable Axillary Approach and Chest-breast Approach Endoscopic Surgery in Radical Resection of Unilateral Thyroid Cancer

MA Ye; MENG You; LUO Yu; XU Jing

doi:10.14033/j.cnki.cfmr.2025.17.016

Abstract：Objective:To compare the effectiveness of non-inflatable axillary approach and chest-breast approach endoscopic surgery in radical resection of unilateral thyroid cancer.Method:A total of 90 patients with unilateral thyroid cancer who admitted to Suzhou Municipal Hospital from April 2023 to July 2024 were selected,they were divided into the control group and the observation group according to different treatment methods,with 45 cases in each group.The control group was given chest-breast approach endoscopic surgery,and the observation group was given non-inflatable axillary approach endoscopic surgery.The perioperative indexes,postoperative complications and postoperative cosmetic effect satisfaction were compared between two groups,and the parathyroid function[parathyroid hormone(PTH),serum calcium]and stress response[adrenaline(Adr),cortisol(Cor)]were compared before and 3 d after operation.Result:Compared with the control group,the bleeding volume,postoperative drainage volume and visual analogue scale(VAS)score at 1 month after operation in the observation group were lower,and the difference was statistically significant(P<0.05);there were no significant differences in the operation time and the number of lymph node dissection between two groups(P>0.05).Compared with the control group,the incidence of postoperative complications in the observation group was lower,while the total satisfaction of postoperative cosmetic effect was higher,and the difference was statistically significant(P<0.05).There were no significant differences in the parathyroid function and stress response between two groups before and 3 d after operation(P>0.05);however,the PTH,serum calcium and Adr at 3 d after operation in two groups were higher than those before operation,and Cor were lower than those before operation,the differences were statistically significant(P<0.05).Conclusion:The operation time and lymph node clearance effect of non-inflatable axillary approach endoscopic surgery and chest-breast approach endoscopic surgery are basically the same,and have little effect on parathyroid gland and stress response.However,non-inflatable axillary approach endoscopic surgery has less blood loss and postoperative drainage,and can reduce the postoperative pain and reduce the incidence of postoperative complications,at the same time,it has high aesthetic effect satisfaction.