|
|
|
| Effects of Endoscopic Thyroidectomy via Breast Areola Approach on Stress Related Hormones in Patients with Benign Thyroid Lesions |
| DAI Yingqi, ZHANG Jinqing |
| The Third Provincial Hospital of Shandong, Shandong Jinan 250000, China |
|
|
|
|
Abstract Objective: To analyze the effects of endoscopic thyroidectomy via breast areola approach on stress related hormones in patients with benign thyroid lesions.Methods: The clinical data of 82 patients with benign thyroid lesions treated in the hospital from January 2016 to October 2018 were collected.40 cases treated with endoscopic thyroidectomy via breast areola approach were included into the laparoscopic group while 42 cases treated with open thyroidectomy were included into the open group.Changes of stress and related hormones such as serum cortisol (Cor), norepinephrine (NE), adrenocorticotropic hormone (ACTH), thyroid stimulating hormone (TSH), thyroid hormones (TT3, FT3, TT4, FT4) before and after operation were compared between the two groups.Changes of visual analogue scale (VAS) scores at different time points after operation were recorded.The operation time, length of incision, intraoperative blood loss, length of hospital stay, and drainage volume were compared between the two groups.The incidence of postoperative complications was statistically analyzed.Results: ①Before operation, there were no statistically significant differences between the two groups in levels of Cor, NE and ACTH (P>0.05).12 hours after operation, the levels of stress hormones increased in the two groups (P<0.05).But the levels of the hormones and the pre- and post-operation difference were lower in the laparoscopic group than in the open group (P<0.05).②There were no statistically significant differences between the two groups in levels of TSH, TT3, FT3, TT4 and FT4 before operation (P>0.05).12 hours after operation, TSH levels decreased while TT3 and FT3 levels increased in the two groups, which was statistically significant compared with pre-operation data (P<0.05), but differences between groups were not statistically significant (P>0.05).③Compared with the open group, the operation time was longer, the length of incision was shorter, the intraoperative blood loss, length of hospital stay, drainage volume, VAS scores at different time points after operation and the incidence of complications were less, shorter or lower in the laparoscopic group (P<0.05).Conclusion: The application of endoscopic thyroidectomy via breast areola approach in the treatment of benign thyroid diseases can reduce postoperative stress reactions and improve the thyroid function.The intraoperative blood loss is little and patients can recover quickly after operation, and the incidence of complications is low.
|
|
|
|
|
|
[1] 章国亮,张国烈,林元美,等.经全乳晕入路腔镜甲状腺手术配合经验总结[J].中国内镜杂志,2019,25(2):18~22.
[2] 李慧,彭小伟,李赞,等.改良经口入路腔镜甲状腺手术的临床应用分析[J].中华外科杂志,2019,57(9):686~690.
[3] 孙文辉,张世伟,赵海平,等.完全经乳晕入路腔镜甲状腺癌手术的临床应用[J].浙江临床医学,2017,19(3):400~401,404.
[4] 邱洪波,唐乐,窦刚,等.全腔镜手术与传统手术治疗早期分化型甲状腺腺癌的临床效果研究[J].河北医学,2018,24(10):1610~1614.
[5] Sbitany H, Wang F, Peled A W, et al. Tissue expander reconstruction after total skin-sparing mastectomy: defining the effects of coverage technique on nipple/areola preservation.[J]. Ann Plas Surg, 2016, 77(1):17~24.
[6] Zhu G, Zhang X, Tang Z, et al. The learning curve of transareola single-site laparoendoscopic thyroidectomy: CUSUM analysis of a single surgeon's experience[J]. Surg Laparosc Endosc Percutan Tech, 2016, 26(5):364~367.
[7] Chien M N, Yang P S, Lee J J, et al. Recurrence-associated genes in papillary thyroid cancer: An analysis of data from The Cancer Genome Atlas.[J]. Surgery, 2017, 161(6):1642~1650.
[8] 彭亚,柳岸,彭小伟.经口腔前庭内镜甲状腺癌切除术治疗甲状腺癌的临床疗效[J].癌症进展,2019,17(13):1531~1533.
[9] 刘文.36例完全经乳晕入路腔镜甲状腺切除术的体会[J].中南医学科学杂志,2018,46(6):664~666. |
|
|
|
2020, Vol. 26 
