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Endoscopic thyroidectomy via an axillo-breast approach without gas insufflation for benign thyroid nodules and micropapillary carcinomas: preliminary results

 Hyun Jun Hong  ;  Won Shik Kim  ;  Yoon Woo Koh  ;  So Yoon Lee  ;  Yoo Seob Shin  ;  Yong Cheol Koo  ;  Yoon A Park  ;  Eun Chang Choi 
 YONSEI MEDICAL JOURNAL, Vol.52(4) : 643-654, 2011 
Journal Title
Issue Date
Adult ; Carcinoma, Papillary/pathology ; Carcinoma, Papillary/surgery* ; Endoscopy/adverse effects ; Endoscopy/methods ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Nodule/pathology ; Thyroid Nodule/surgery* ; Thyroidectomy/adverse effects ; Thyroidectomy/methods* ; Treatment Outcome
Endoscopic thyroidectomy ; thyroid cancer ; thyroid tumor ; vocal cord palsy ; hypocalcaemia
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, ≥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≤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 ≥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.
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1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Koh, Yoon Woo(고윤우)
Kim, Won Shik(김원식)
Shin, Yoo Seob(신유섭)
Lee, So Yoon(이소윤)
Choi, Eun Chang(최은창)
Hong, Hyun Jun(홍현준) ORCID logo https://orcid.org/0000-0002-7808-7877
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