The clinical application and learning curve of endoscopic thyroidectomy via chest-areolar approach / 实用医学杂志

ABSTRACT

Objective To examine the clinical effect and learning curve of endoscopic thyroidectomy via chest-areolar approach in the treatment of benign thyroid nodules. Methods From January 2012 to May 2016,49 patients underwent endoscopic thyroidectomies via chest-areolar approach in Xuanwu Hospital ,Capital medical university. The clinical characteristics ,prognosis and operation time were retrospectively analyzed. The patients were divided into 9 groups according to the surgical sequence ,and the learning curves were analyzed by using moving average method. Results 49 endoscopic thyroidectomies via chest-areolar approach were performed successfully. The average size of the nodules was(2.80 ± 0.62)cm. 10 patients underwent bilateral thyroidectomy and 39 underwent unilateral thyroidectomy. The average operation time was(157.49 ± 21.23)min. 2 cases received re-operation due to postoperative pathology of malignancy. There were no postoperative recurrent laryngeal nerve injuries. 11 patients suffered from asymptomatic hypocalcemia with parathyroid hormone in the normal range. All of the patients were satisfied with the cosmetic results. The learning curves indicated that 35 endoscopic thyroidectomies were needed to be performed in the early study stage. Conclusions For surgeons with experience of conventional thyroidectomies,endoscopic thyroidectomy via chest-areolar approach is feasible and safe for selected patients. There is a significant learning curve in the application of endoscopic thyroidectomy. In the early study stage of endo-scopic thyroidectomy,35 cases are basically required for beginning surgeons to practice the surgical operation.