经口腔前庭入路与经乳晕入路腔镜甲状腺切除术对甲状腺微小乳头状癌 VAS 评分、创伤- 免疫指标及美观程度的影响.

Objective: To compare the effects of transoral endoscopic thyroidectomy vestibular approach (TOETVA) and via areola of breasts approach endoscopic thyroidectomy (ETE) on visual pain simulation (VAS) score, trauma-immune index and aesthetic degree of thyroid micropapillary carcinoma. Methods: The clinical data of 100 patients with thyroid micropapillary carcinoma who were received in our hospital from March 2020 to December 2021 were analyzed retrospectively. The patients were divided into group A (n=47, treated with ETE) and group B (n=53, treated with TOETVA) according to different approaches. Perioperative indexes, trauma-immune indexes, aesthetic degree and complication rate were compared in the two groups. Results: There were no differences between the two groups in the intraoperative blood loss, the number of central lymph nodes dissected and postoperative hospital stay (P>0.05). The operation time in the group B was longer than that in the group A, and the VAS score of the neck on the first day after operation was lower than that in the group A (P<0.05). CD8+, interleukin-6 (IL-6), C-reactive protein (CRP) and cortisol (Cor) increased in the two groups at 3 d after operation, but the group B was lower than the group A (P<0.05). CD4+ decreased in the two groups at 3 d after operation, but the group B was higher than the group A (P<0.05). The scores of Vancouver scar scale (VSS) and Patient and observer scar assessment scale (POSAS) in the group B were lower than those in the group A (P<0.05). There was no significant difference in the incidence of complications in the two groups(P>0.05). Conclusion: Compared with ETE, TOETVA can achieve a comparable surgical effect in the treatment of thyroid micropapillary carcinoma, and TOETVA can better reduce postoperative pain, postoperative trauma, and improve aesthetics. [ABSTRACT FROM AUTHOR]