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Comparative study of endoscopic thyroidectomy versus conventional open thyroidectomy in papillary thyroid microcarcinoma (PTMC) patients

Authors
 JONG JU JEONG  ;  SANG-WOOK KANG  ;  JI-SUP YUN  ;  TAE YON SUNG  ;  SEUNG CHUL LEE  ;  YONG SANG LEE  ;  KEE-HYUN NAM  ;  HANG SEOK CHANG  ;  WOONG YOUN CHUNG  ;  CHEONG SOO PARK 
Citation
 JOURNAL OF SURGICAL ONCOLOGY, Vol.100(6) : 477-480, 2009 
Journal Title
JOURNAL OF SURGICAL ONCOLOGY
ISSN
 0022-4790 
Issue Date
2009
MeSH
Adult ; Aged ; Carcinoma, Papillary/surgery* ; Endoscopy* ; Female ; Humans ; Lymph Node Excision/statistics & numerical data ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Postoperative Complications ; Thyroglobulin/blood ; Thyroid Neoplasms/surgery* ; Thyroidectomy/methods* ; Time Factors
Keywords
endoscopic thyroid surgery ; conventional open thyroid surgery ; papillary thyroid microcarcinoma ; surgical outcome
Abstract
BACKGROUND: The aim of this study was to evaluate and compare the early surgical outcomes of endoscopic and conventional open thyroidectomies in patients with papillary thyroid microcarcinoma (PTMC).

METHODS: Between September 2005 and December 2007, 499 patients with PTMC were enrolled. 275 patients underwent gasless endoscopic thyroidectomy via the axillary route (endo group), and 224 patients underwent conventional open thyroidectomy (open group). We analyzed the patient's clinico-pathologic characteristics and surgical completeness between the two groups.

RESULTS: The endo group was younger than the open group. The open group underwent more extensive surgery than the endo group. The operative time was longer in the endo group than the open group (138.5 +/- 49.0 min vs. 105.5 +/- 41.6 min; P < 0.0001), and a lesser number of lymph nodes were retrieved in the endo group compared to the open group (5.05 +/- 2.94 vs. 5.96 +/- 4.50, P = 0.007). We experienced complications in the endo group, such as transient hypocalcemia, transient RLN palsies, tracheal injuries, and esophageal injuries. There was no abnormal uptake on RAI scans in the two groups. From among patients who had undergone total thyroidectomy, all patients in the endo group had <1 ng/ml of serum Tg post-operatively; the seven patients in the open group had >1 ng/ml of serum Tg post-operatively. Tumor recurrence was detected in the open group only (n = 6). Also we checked the post-operative Tg in patients who had undergone lobectomy in the two groups, and found that there were no statistical differences in the two groups.

CONCLUSIONS: According to our experience, gasless endoscopic thyroidectomy using a trans-axillary approach is a safe and feasible alternative to conventional open thyroidectomy in selected patients with PTMC
Full Text
http://onlinelibrary.wiley.com/doi/10.1002/jso.21367/abstract
DOI
10.1002/jso.21367
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Sang Wook(강상욱) ORCID logo https://orcid.org/0000-0001-5355-833X
Nam, Kee Hyun(남기현) ORCID logo https://orcid.org/0000-0002-6852-1190
Park, Cheong Soo(박정수)
Sung, Tae Yon(성태연)
Lee, Seung Chul(이승철)
Lee, Yong Sang(이용상) ORCID logo https://orcid.org/0000-0002-8234-8718
Chang, Hang Seok(장항석) ORCID logo https://orcid.org/0000-0002-5162-103X
Chung, Woong Youn(정웅윤)
Jeong, Jong Ju(정종주) ORCID logo https://orcid.org/0000-0002-4155-6035
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/105503
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