Impact of Modified Thoracic Breast Approach Lumpectomy on Prognosis of Recurrence in Radical Thyroid Carcinoma Patients.

OBJECTIVE

This study aimed to compare the efficacy and safety of endoscopic radical thyroidectomy (ERT) via modified breast approach (MBA) with conventional open thyroidectomy in treating thyroid carcinoma (TC).

METHODS

One hundred patients with TC were randomized into a research group (treated with modified thoracic breast approach lumpectomy) and a control group (treated with traditional open surgery). Clinical efficacy, adverse effects, operative time, intraoperative bleeding, postoperative drainage, and length of stay (LOS) were compared between the groups. Serum calcium and parathyroid hormone levels were measured preoperatively and on postoperative days 1 and 5. Patients were followed up for 1-year prognosis, including prognostic survival, TC recurrence rate, and factors affecting their prognosis.

RESULTS

There was no difference in total treatment efficiency between the groups, but the incidence of adverse effects, intraoperative bleeding, postoperative drainage, and LOS were lower in the research group, while the operative time was higher in the control group. Serum calcium and parathyroid hormone were insufficient in both groups on postoperative day 1 compared to preoperative levels, with higher levels in the research group. On postoperative day 5, there was no difference between the groups. TC recurrence was lower in the research group, and logistic regression analysis showed that age and surgical method were independent factors affecting prognostic recurrence in TC patients.

CONCLUSION

Modified thoracic breast approach lumpectomy for radical TC is a safe and effective technique that can improve patients' prognosis of recurrence. It is recommended for clinical practice.