Total or Near-total Thyroidectomy in treatment of Thyroid Cancer

Objectives: To observe the clinical efficacy on total or near-total thyroidectomy in the treatment of thyroid cancer.

Methods: Ninety-four patients with thyroid cancer treated in Meiris Branch of the First Affiliated Hospital of Qiqihar Medical College from June 2018 to June 2020 were selected as subjects. According to different surgical methods, they were divided into observation group and control group, with 47 patients in each group. The control group was treated with total thyroidectomy, while the observation group received near-total thyroidectomy. The two groups were both followed up for one year. The therapeutic effect, surgery-related indexes (surgical duration, intraoperative bleeding volume, postoperative analgesia time and postoperative 24-h VAS score), the incidence of complications three months after surgery, and the serum levels of relevant indexes [parathyroid hormone (PTH), calcium ion (Ca2+) and signal transducer and activator of transcription 3 (STAT3)] before and 14 d after surgery were compared between the two groups. The difference in quality of life [the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)] between the two groups one year after surgery was observed.

Results: During the one year follow-up, there was no death in both groups. The total efficacy of the observation group was higher than that of the control group (0.05). The surgical duration, postoperative analgesia time and postoperative 24-h VAS score of the observation group were higher than those of the control group (p<0.05). However, no statistically significant difference was found in intraoperative bleeding volume between the two groups (p> 0.05). Three months after surgery, the total incidence of postoperative complications in the observation group was higher than that in the control group (p< 0.05). Fourteen days after surgery, the levels of PTH, Ca2+ and STAT3 in the two groups were lower than those before surgery, and the levels in the observation group were lower than those in the control group (p< 0.05). One year after surgery, cognitive, emotional, role, social and physical scores in the observation group were all lower than those in the control group, without statistically significant differences (p> 0.05).

Conclusion: Total thyroidectomy is effective in the treatment of thyroid cancer, but has many postoperative complications. Clinicians need to choose the appropriate surgical method according to the actual condition of patients.