Objective To compare the therapeutic effects between endoscopic thyroidectomy by anterior chest approach and modified Miccoli thyroidectomy. Methods Sixty patients with thyroid goiter were performed endoscopic thyroidectomy by anterior chest approach (endoscopic thyroidectomy by anterior chest approach group, n=30) and modified Miccoli thyroidectomy (modified Miccoli group, n=30) respectively. The operative time, the drainage volume, cosmetic benefit, the postoperative hospitalization time, the expenses of hospitalization and postoperative complications of two groups were compared. Results The operative time and the drainage volume after operation of endoscopic thyoidectomy by anterior chest approach group were significantly more than modified Miccoli group 〔(99.9±23.4) min vs. (74.0±29.6) min; (68.6±8.7) ml vs. (40.9±6.1) ml, respectively〕, Plt;0.05. The cosmetic benefit score of endoscopic thyoidectomy by anterior chest approach group was higher than that of modified Miccoli group 〔(4.7±0.2) points vs. (3.7±0.1) points〕, Plt;0.05. The postoperative hospitalization time and expenses of hospitalization were no significant differences between the two groups 〔(6.5±1.7) d vs. (5.5±0.9) d; (9 328.3±1 107.1) yuan vs. (8 568.2±1 032.3) yuan, respectively〕, Pgt;0.05. One case had transient hoarseness in 2 groups respectively, no other complications happened. Conclusions Modified Miccoli operation is both minimally invasive and cosmetic, but endoscopic thyroidectomy by anterior chest approach has better cosmetic benefit, which can release patients’ psychological trauma. The patients with specific cosmetic demand may choose endoscopic thyroidectomy by anterior chest approach.
Objective To compare the therapeutic efficacy between the mini-incision anterior cervical approach thyroidectomy and modified Miccoli endoscopy assisted thyroidectomy for thyroid benign tumor. Methods Clinical data of 80 patients with thyroid benign tumor treated in The First Affiliated Hospital of General Hospital of PLA from Jan.2010 to Jan. 2012 were retrospectively analyzed，and the 80 patients were divided into mini-incision anterior cervical approach thyroidectomy group （n=40） and modified Miccoli endoscopy assisted thyroidectomy group （n=40） according to operative type. The operative time，drainage volume of neck，cosmetic satisfaction score，duration of hospitalization，expense of hospitalization，and rates of postoperative complication of 2 groups were compared and analyzed. Results The operative time of mini-incision anterior cervical approach thyroidectomy group were significantly longer than that ofmodified Miccoli endoscopy assisted thyroidectomy group〔（95.5±20.3）min vs. （62.4±15.5）min，P＜0.05〕，but thecosmetic satisfaction score〔（3.5±0.2） score vs. （4.3±0.1） score〕and expense of hospitalization〔（5 814.6±1 262.3）yuan vs. （9 846.7±1 080.5） yuan〕were lower （P＜0.05）. There were no significant differences on the drainage volumeof neck after operation〔（28.6±5.5） mL vs. （22.2±4.5） mL〕and duration of hospitalization〔（4.5±1.5） d vs. （3.8±0.9） d〕between the 2 groups （P＞0.05）. There were 3 cases happened transient hoarseness in mini-incision anterior cervical approach thyroidectomy group （all recovered in 1 month after operation） and 1 case in modified Miccoli endoscopy assi-sted thyroidectomy group （recovered in 3 months after operation），and there were no significant difference on incidence of recurrent laryngeal nerve injury （P=0.608）. No other complications happened. Conclusions Modified Miccoli endoscopy assisted thyroidectomy has better cosmetic benefit than mini-incision anterior cervical approach thyroidectomy， but more expensive. The patients who have specific cosmetic demand or engage in special profession can choose modified Miccoli endoscopy assisted thyroidectomy.