Comparison of Endoscopic (Breast-axillary Approach) Versus Conventional Open Thyroid Lobectomy
Keywords:
Endoscopic thyroidectomy, Open thyroidectomy, OutcomesAbstract
Objective: To compare the outcomes and complications of endoscopic versus conventional open thyroidlobectomy
Patients and Methods: A retrospective, group-matched control study was performed in 148 patients who
underwent thyroid lobectomy at the institute by one surgeon (the author) between October 2008 and September 2014.
Results: Endoscopic thyroidectomy (ET) was done successfully in 71 patients with a median age of 40 years and
median tumor size of 3 cm. Conventional open thyroidectomy (OT) was done in 77 patients with a median age of 42
years and median tumor size of 4 cm. There were no significant differences in sex, age, side of tumor between the two
groups. Median operative time was significantly longer in the ET group at 120 min (range 50 to 180) vs. the OT group
at 75 min (range 50 to 130), p < 0.05. Median postoperative pain score, rated from 1 to 10, was significantly less in the
ET group at both 24 hours and 48 hours, and blood loss was significantly less in the ET group (both p-values < 0.05).
Median postoperative hospital stay in ET group was shorter than that in the OT group: 3 days (range 2 to 5) vs. 4 days
(range 2 to 6) respectively (p < 0.05). There was no significant difference in the complication rates, but the cosmetic
satisfaction was significantly superior in the ET group.
Conclusion: ET (breast-axillary approach) is safe and superior to OT in terms of postoperative pain, blood loss,
hospital stay, and cosmesis for patients undergoing thyroid lobectomy.
References
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minimally invasive video-assisted thyroidectomy: a
prospective randomized study. Surgery 2001;30:1039-43.
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thyroidectomy: five years of experience. J Am Coll
Surg 2004;199:243-8.
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Neck Surg 2010;143:789-94.
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thyroidectomy versus conventional thyroidectomy: a singleblind
randomized controlled clinical trial. J Minim Access
Surg 2009;5:97-102.
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approaches to endoscopic thyroid surgery. Surg Endosc
2011;25:995-1003.
24. Kim WS, Hong HJ, Shin YS, et al. Increase the size limit of
benign thyroid lesions resectable by endoscopic
thyroidectomy via a unilateral axillo-breast approach without
gas insufflation. World J Surg 201;35:2203-11.
25. Pisanu A, Podda M, RecciaI, et al. Systematic review with
meta-analysis of prospective randomized trials comparing
minimally invasive video-assisted thyroidectomy (MIVAT)
and conventional thyroidectomy (CT). Langenbecks Arch
Surg 2013;398:1057-68.
26. Radford PD, Mark S, Ferguson JC, et al. Meta-analysis of
minimally invasive video-assisted thyroidectomy.
Laryngoscope 2011;121:1675-81.
27. Ji YB, Song CM, Bang HS ,et al. Long-term cosmetic outcomes
after robotic/endoscopic thyroidectomy by a gasless
unilateral axillo-breast or axillary approach. J Laparoendosc
Adv Surg Tech A. 2014;24:248-53.
28. Cao F, Jin K, Cui B, et al. Learning curve for endoscopic
thyroidectomy: a single teaching hospital study. Onco
Targets Ther 2013;6:47-52.
29. Hong HJ, Kim WS, Koh YW, et al. Endoscopic thyroidectomy
via an axillo- breast approach without gas insufflation for
benign thyroid nodules and micropapillary carcinomas:
preliminary results. Yonsei Med J. 2011;52:643-54.
30. Lee MC, Mo JA, Choi IJ, et al. New endoscopic thyroidectomy
via a unilateral axillo-breast approach with gas insufflation:
preliminary report. Head Neck 2013;35:471-6.
right thyroid lobectomy. Surg Endosc 1997;11:877.
2. Yeung GH. Endoscopic surgery of the neck: a new frontier.
Surg Laparosc Endosc 1998; 277-32.
3. Miceoli P. Berti P, CouteM et al. Minimally invasive surgery for
small thyroid nodules : preliminary report. J Endocrinol Invest
1999;22:849-51.
4. Shimizu K, Akira S, Jasmi AY, et al. Video-assisted neck
surgery: endoscopic resection of thyroid tumors with a very
minimal neck wound. J Am Coll Surg 1999;188:697-703.
5. Slotema ET, Sebag F, Henry JF. What is the evidence for
endoscopic thyroidectomy in the management of benign
thyroid disease? World J Surg 2008;32:1325-32.
6. Lombardi CP, Raffaelli, DeCrea MC. Video-assisted
thyroidectomy: lesson learned after more than one decade.
Acta Otorhino Laryngol Ital 2009;29:317-20.
7. Lui J, Song T, Xu M. Minimally invasive video-assisted versus
conventional open thyroidectomy: a systematic review of
available data. Surg Today 2012;42:848-56.
8. Miccoli P, Minuto MN, Ugolini C, et al. Minimally invasive
video-assisted thyroidectomy for benign thyroid disease: an
evidence-based review. World J Surg. 2008;32:1333-40.
9. Sgourakis G, Sotiropoulos GC, Neuhauser M, et al.
Comparison between minimally invasive video-assisted
thyroidectomy and conventional thyroidectomy: is there
any evidence-based information? Thyroid 2008;18:721-7.
10. El-Labban GM. Minimally invasive video assisted
thyroidectomy versus conventional thyroidectomy: A singleblinded,
randomized controlled clinical trial. J Minim Access
Surg. 2009;5:97-102.
11. Shuja A. History of thyroid surgery. Professional Med J 2008;
15:295-7.
12. วุฒิชัย ธนาพงศ. Principles of laparoscopic Surgery. ศัลยศาสตร์ทั่วไป Vol. 2 Minimally invasive surgery 2547:26-7.
13. สุชาติ จันทวิบูลย์. Endoscopic thyroidectomy. ศัลยศาสตร์ทั่วไป.
Vol. 2 Minimally invasive surgery 2547:105-6.
14. Bellantone R, Lombardi CP, Bossola M.Video-assisted vs
conventional thyroid lobectomy. Arch Surg 2002;137:301-4.
15. Rubin AD. Complication of thyroid surgery. eMed J 2001;.2:9.
16. Garilan J.,Gabilan C. Recurrent laryngeal nerve:
identification during thyroid and parathyroid surgery. Arch
Otolarygol Head Neck Surg 1986;112:1286.
17. สุมิต วงศ์เกียรติขจร. Post thyroidectomy complications.
ธัยรอยด์ และพาราธัยรอยด์. 2545:456-7.
18. Ikeda Y, TakamiH, Sasaki Y, et al. Comparative studies of
thyroidectomies: endoscopic surgery vs conventional open
surgery. Surg Endosc 2002;16:1741-5.
19. Miccoli P, Berti P, Raffaelli M, et al. Comparison between
minimally invasive video-assisted thyroidectomy: a
prospective randomized study. Surgery 2001;30:1039-43.
20. Miccoli P, Berti P, Materazzi G. Minimally invasive videoassisted
thyroidectomy: five years of experience. J Am Coll
Surg 2004;199:243-8.
21. Byrd JK, Nguyen SA, KetchamA, et al. Minimally invasive
video-assisted thyroidectomy versus conventional
thyroidectomy: a cost -effective analysis. Otolaryngol Head
Neck Surg 2010;143:789-94.
22. El-Labban GM. Minimally invasive video-assisted
thyroidectomy versus conventional thyroidectomy: a singleblind
randomized controlled clinical trial. J Minim Access
Surg 2009;5:97-102.
23. Papaapyrou G, Ferlito A, Silver CE, et al. Extracervical
approaches to endoscopic thyroid surgery. Surg Endosc
2011;25:995-1003.
24. Kim WS, Hong HJ, Shin YS, et al. Increase the size limit of
benign thyroid lesions resectable by endoscopic
thyroidectomy via a unilateral axillo-breast approach without
gas insufflation. World J Surg 201;35:2203-11.
25. Pisanu A, Podda M, RecciaI, et al. Systematic review with
meta-analysis of prospective randomized trials comparing
minimally invasive video-assisted thyroidectomy (MIVAT)
and conventional thyroidectomy (CT). Langenbecks Arch
Surg 2013;398:1057-68.
26. Radford PD, Mark S, Ferguson JC, et al. Meta-analysis of
minimally invasive video-assisted thyroidectomy.
Laryngoscope 2011;121:1675-81.
27. Ji YB, Song CM, Bang HS ,et al. Long-term cosmetic outcomes
after robotic/endoscopic thyroidectomy by a gasless
unilateral axillo-breast or axillary approach. J Laparoendosc
Adv Surg Tech A. 2014;24:248-53.
28. Cao F, Jin K, Cui B, et al. Learning curve for endoscopic
thyroidectomy: a single teaching hospital study. Onco
Targets Ther 2013;6:47-52.
29. Hong HJ, Kim WS, Koh YW, et al. Endoscopic thyroidectomy
via an axillo- breast approach without gas insufflation for
benign thyroid nodules and micropapillary carcinomas:
preliminary results. Yonsei Med J. 2011;52:643-54.
30. Lee MC, Mo JA, Choi IJ, et al. New endoscopic thyroidectomy
via a unilateral axillo-breast approach with gas insufflation:
preliminary report. Head Neck 2013;35:471-6.
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Published
2015-03-30
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Wisanuyothin T. Comparison of Endoscopic (Breast-axillary Approach) Versus Conventional Open Thyroid Lobectomy. Thai J Surg [Internet]. 2015 Mar. 30 [cited 2024 Nov. 22];36(1). Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/226244
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