Endoscopic Thyroidectomy via an Axillo-Breast Approach without Gas Insufflation for Benign Thyroid Nodules and Micropapillary Carcinomas: Preliminary Results.
10.3349/ymj.2011.52.4.643
- Author:
Hyun Jun HONG
1
;
Won Shik KIM
;
Yoon Woo KOH
;
So Yoon LEE
;
Yoo Seob SHIN
;
Yong Cheol KOO
;
Yoon A PARK
;
Eun Chang CHOI
Author Information
1. Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea. ywkohent@yuhs.ac
- Publication Type:Original Article
- Keywords:
Endoscopic thyroidectomy;
thyroid cancer;
thyroid tumor;
vocal cord palsy;
hypocalcaemia
- MeSH:
Adult;
Carcinoma, Papillary/pathology/*surgery;
Endoscopy/adverse effects/methods;
Female;
Humans;
Male;
Middle Aged;
Retrospective Studies;
Thyroid Nodule/pathology/*surgery;
Thyroidectomy/adverse effects/*methods;
Treatment Outcome
- From:Yonsei Medical Journal
2011;52(4):643-654
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To examine the feasibility of endoscopic thyroidectomy (ET) via an axillo-breast approach without gas insufflation for large thyroid tumors and micropapillary carcinomas. MATERIALS AND METHODS: The patients in the benign group were separated into groups 1 (n=95, <4 cm in tumor diameter) and 2 (n=37, > or =4 cm in tumor diameter). Also, 57 patients in the micropapillary carcinoma group underwent an endoscopic hemithyroidectomy (HT) (group 3) and were compared with 60 patients who received conventional open HT (group 4). Postoperative functional outcome, local complications, surgical outcomes, and pathological outcomes were compared between the groups. RESULTS: In the benign group, there was no significant difference in mean operating time, hospital stay, or overall perioperative complications between the two groups. In the micropapillary carcinoma group, mean operating time and hospital stay in group 3 were significantly longer than in group 4 (p=0.015 and p< or =0.001). The overall perioperative complications did not differ significantly between the groups. The postoperative cosmetic result was better in groups 1-3 (endo group) than in group 4 (open group). CONCLUSION: ET via a gasless axillo-breast approach seems to be a safe procedure even for benign thyroid lesions > or =4 cm and micropapillary carcinomas. Although it has the advantage of better cosmetic results over open thyroidectomy, there is room for improvement in terms of lessening its invasiveness and shortening the operative time.
