Effect of endoscopic thyroidectomy via anterior chest wall approach on treatment of benign thyroid tumors.
OBJECTIVE
The aim of this study was to evaluate the inflammatory response and acid-base equilibrium index, as well as other clinical facts of the endoscopic thyroidectomy via the anterior chest wall approach.


METHODS
Thirty-nine patients who received thyroidectomy in our surgical center during September 2007 and January 2008 were included in this study. Twenty of the patients underwent an endoscopic surgery, and the remaining 19 received conventional surgery. These patients' data were compared within and between treatment groups with respect to clinical facts and inflammatory evaluations. Arterial blood gas data and electrolyte data were analyzed within the endoscopic group.


RESULTS
Endoscopic thyroidectomy group showed shorter operative time, compared to that of the conventional thyroidectomy group, although the difference didn't reach statistical significance. No significant difference regarding postoperative hospital stay was observed between two groups. Postoperative day 1 shows much higher values of interleukin-6 and tumor necrosis factor than that measured preoperative or postoperative day 3 in both groups. C-reactive protein appeared to be significantly increased postoperatively in both groups, although no difference between the two groups was found. Although blood cortisol significantly increased in both groups postoperatively, the data of endoscopic group postoperative day 1 was lower than the same day of the conventional group. Arterial blood gas analysis showed that both PCO2 and TCO2 were statistically different between preoperation and 30 minutes after insufflation. No insufflation complication was observed.


CONCLUSIONS
Compared with conventional thyroid surgery, endoscopic thyroidectomy via the anterior chest wall approach presented with no significant difference in respect of both clinical facts and laboratory outcomes.
Shanghai Minimally Invasive Surgery Center, Surgery Department, Shanghai Ruijin Hospital affiliated with Shanghai JiaoTong University Medical School, Shanghai, China.
Mingliang
M
Wang
Tao
T
Zhang
Zhihai
Z
Mao
Feng
F
Dong
Jianwen
J
Li
Aiguo
A
Lu
Weiguo
W
Hu
Lu
L
Zang
Yu
Y
Jiang
Minhua
M
Zheng
D000136:Acid-Base Equilibrium; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001784:Blood Gas Analysis; D002097:C-Reactive Protein / Q000378:metabolism; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008875:Middle Aged; D035441:Thoracic Wall / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D006854:Hydrocortisone