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Gasless transaxillary endoscopic thyroidectomy: a decade on

 Nor Azham Hakim Darail  ;  So Hee Lee  ;  Sang Wook Kang  ;  Jong Ju Jeong  ;  Kee Hyun Nam  ;  Woong Youn Chung 
 Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, Vol.24(6) : 211-215, 2014 
Journal Title
 Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 
Issue Date
Adolescent ; Adult ; Aged ; Child ; Combined Modality Therapy ; Endoscopy/methods* ; Endoscopy/statistics & numerical data ; Endoscopy/trends ; Female ; Follow-Up Studies ; Humans ; Iodine Radioisotopes/therapeutic use ; Male ; Middle Aged ; Neoplasm Recurrence, Local/etiology ; Postoperative Care/methods ; Postoperative Complications/etiology ; Preoperative Care/methods ; Radiopharmaceuticals/therapeutic use ; Thyroid Neoplasms/radiotherapy ; Thyroid Neoplasms/surgery* ; Thyroidectomy/methods* ; Thyroidectomy/statistics & numerical data ; Thyroidectomy/trends ; Treatment Outcome ; Young Adult
PURPOSE: In 2001, the authors developed a novel method of gasless transaxillary endoscopic thyroidectomy (ET) and have now performed >1000 operations. This review was performed to document surgical outcomes after 10 years of experience with this technique and to determine what the role of ET has in the current era. PATIENTS AND METHODS: All patients who underwent elective ET using the gasless transaxillary approach from November 2001 to December 2010 were evaluated. Patient demographics, surgical data, histologic analysis results, and complications were recorded and analyzed. RESULTS: A total of 1085 patients underwent ET during the study period. Mean patient age was 36.9±9.7 years; the gender ratio was 1:49 (male:female). There were 228 benign thyroid tumor cases and 857 thyroid malignancies. Trend analysis showed a progressive increase in case numbers per month until the end of 2007, followed by a steady decline. There were 175 total thyroidectomy cases and 910 cases of less-than-total thyroidectomy. Mean overall operating time was 132.92±48.6 minutes, and the overall complication rate was 13.5%. The most common complications were: transient hypocalcemia (6.3%), transient hoarseness (3.9%), hematoma (0.4%), permanent hypocalcemia (0.1%), and permanent recurrent laryngeal nerve injury (0.2%). CONCLUSIONS: Gasless ET is comparable to open thyroidectomy in terms of early surgical outcomes and complications, and it bridges the gap between conventional open surgery and robotic transaxillary thyroidectomy.
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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
Lee, So Hee(이소희)
Chung, Woung Youn(정웅윤)
Jeong, Jong Ju(정종주) ORCID logo https://orcid.org/0000-0002-4155-6035
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