Korean J Endocr Surg.  2016 Jun;16(2):42-47. 10.16956/kaes.2016.16.2.42.

Transaxillary Endoscopic Thyroidectomy versus Conventional Open Thyroidectomy for Papillary Thyroid Cancer: 5-year Surgical Outcomes

• Koh WR
• Chae BJ
• Bae JS
• Song BJ
• Eom YH
• Lee S

• KMID: 2308569
• DOI: http://doi.org/10.16956/kaes.2016.16.2.42

Abstract

PURPOSE
The early surgical outcomes of endoscopic thyroidectomy in papillary thyroid cancer (PTC) are comparable to those of conventional open thyroidectomy; however, there is little evidence about long-term outcomes. The aim of this study was to compare the 5-year surgical outcomes of endoscopic versus open thyroidectomy.
METHODS
We reviewed 804 patients with PTC who underwent thyroidectomy between October 2008 and October 2010. Of these, 703 patients received conventional open thyroidectomy (OT group) and 101patients underwent endoscopic thyroidectomy (ET group). The clinicopathologic characteristics and surgical outcomes were compared between those treatments.
RESULTS
ET was applied significantly more often in young patients and females. The lobectomy and unilateral CCND were performed more frequently in ET, and the mean tumor size was smaller. The prevalence of extrathyroidal extension, multiplicity, and lymphatic invasion was more frequent in OT. The T and TNM stage were more advanced in OT, whereas the N status was similar between treatments. The mean surgical time was significantly longer for ET, while the number of retrieved lymph nodes was greater in OT. However, the stimulated thyroglobulin levels at first RAI ablation, total amount of RAI administration and 5-year recurrence rate did not significantly differ between groups. The incidence of transient hypocalcemia was significantly higher in OT, but the incidence of permanent hypocalcemia and transient/permanent recurrent laryngeal nerve injury were similar in both groups.
CONCLUSION
Endoscopic thyroidectomy might be a safe and effective procedure in well-selected PTC patients

Keyword

Endoscopic thyroidectomy; Conventional open thyroidectomy; Surgical outcomes

MeSH Terms

Female
Humans
Hypocalcemia
Incidence
Lymph Nodes
Operative Time
Prevalence
Recurrence
Recurrent Laryngeal Nerve Injuries
Thyroglobulin
Thyroid Gland*
Thyroid Neoplasms*
Thyroidectomy*
Thyroglobulin

Figure

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  Fig. 1. Immediately after CNB, a pericapsular hematoma was found.

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  Fig. 2. Two hours after core needle biopsy. (A) A large subplatysmal hematoma anterior to the thyroid gland. (B) Color flow image showing the blood flow, indicating active bleeding.

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