ABSTRACT
Objective To investigate the causes and prevention of hemorrhage and recurrent laryngeal nerve injury during the endoscopic thyroidectomy via the breast areola approach.Methods Totally 36 patients underwent endoscopic thyroidectomy via the breast areola approach from January 2006 to January 2008.Results All the procedures were completed under an endoscope with a mean operation time of 105 min(50 to 180 min),and mean blood loss of 30 ml(20 to 150 ml).None of the patients were converted to an open surgery.One patient developed fat liquefaction,and one showed subcutaneous emphysema,no patient had injuries to any of the nerves or the parathyroid glands.The drainage tube was removed in 24 to 72 months after the surgery.The patients were discharged from the hospital 3 to 7 days postoperation.Postoperative pathological examination showed thyroid adenoma in 7 cases and thyroid nodular goiter in 29.The 36 patients were followed up for 3 to 24 months with a mean of 12 months.During the period,3 patients complained of chest symptoms and were cured spontaneously in 3 to 7 months.All the patients were satisfied with the aesthetic outcomes,none of them had local recurrence of the tumor.Conclusions Endoscopic thyroidectomy via the breasts areola approach is feasible and effective with good short-term and aesthetic outcomes.