J Korean Surg Soc.  2010 Nov;79(5):326-331. 10.4174/jkss.2010.79.5.326.

10 Year-Experience of Endoscopic Thyroidectomy for Papillary Thyroid Microcarcinoma in Single Institution: Breast Approach and Gasless Transaxillary Approach

• Kim YE
• Kwak HN
• Kim JH
• Choi YJ
• Yun JS
• Son BH
• Park YL

• KMID: 2212036
• DOI: http://doi.org/10.4174/jkss.2010.79.5.326

Abstract

PURPOSE
Endoscopic thyroid surgery has been widely used because of the cosmetic advantage and the development of laparoscopic instruments. We have performed endoscopic thyroidectomy by breast approach and gasless transaxillary approach on papillary thyroid microcarcinomas. In this study, we describe these two types of endoscopic procedures with the technique of the method and surgical outcomes.
METHODS
From Oct. 1999 to Oct. 2009, each procedure was performed in 162 patients divided into two groups. Breast approach group was in 91 patients and gasless transaxillary approach group was in 71 patients. We compared the results of mean ages, sex ratio, extent of operation, mean hospital stay, operating time, pathologic characteristics and postoperative complications between the breast approach group and gasless transaxillary approach group.
RESULTS
Ninety-one cases treated using breast approach, and seventy-one cases treated using gasless transaxillary approach. The operation time was 197.4+/-60.7 minutes (95~350) in breast approach group, and 100.1+/-19.8 minutes (65~140) in gasless transaxillary approach group. Post operative complications are; 2 cases of transient hoarseness, 8 cases of hypocalcemia (including 2 cases of permanent hypocalcemia), 2 cases of chest wall discomfort in breast approach group, and 1 case of transient hoarseness, 2 cases of transient hypocalcemia, 1 case of postoperative bleeding in gasless axillary approach group.
CONCLUSION
Endoscopic thyroidectomy is a safe and technically feasible alternative to conventional thyroidectomy in patients with benign and highly selected malignant disease. We expect it can increase the extent of surgery.

Keyword

Endoscopic thyroidectomy; Papillary thyroid microcarcinoma; Breast approach; Gasless transaxillary approach

MeSH Terms

Breast
Carcinoma, Papillary
Cosmetics
Hemorrhage
Hoarseness
Humans
Hypocalcemia
Imidazoles
Length of Stay
Nitro Compounds
Postoperative Complications
Sex Ratio
Thoracic Wall
Thyroid Gland
Thyroid Neoplasms
Thyroidectomy
Carcinoma, Papillary
Cosmetics
Imidazoles
Nitro Compounds
Thyroid Neoplasms