Some remarks on endoscopic thyroidectomy with anterior breast wall and axillary approach: 2000 cases with nodules located in 1 lobe

ABSTRACT

Conventional thyroidectomy requires a transverse cervical incision and a cutting of myocutaneos flaps to gain access to the thyroid. This approach leaves an undesirable scar on the anterior surface of the neck especially for young patients. Endoscopic thyroidectomy is a new minimally invasive technique that permits thyroid excision results of conventional thyroidectomy. From May 2003 to January 2005, the authors have performed 200 cases of endoscopic thyroidectomy at Surgical Department of national Hospital of Endocrinology. The indication for operation included thyroid nodule multinodules located in 1 lobe. The average of nodule size is 2.6cm (1.0-5.6cm). To access the thyroid, the authors use 2 approach: breast approach (100 cases) and auxiliary approach (100 cases) - There are 122 cases of lobectomy (61%), 78 of subtotal lobectomy (39.0%). - The mean operative time was 98.6 minutes (40-180), the mean blood loss was 8.6ml(0-100). - There is no mortality, the life-threaten complication as well as the hypocalcimia and there is not the conversion to open surgery. There is only one patient of the transient hoarseness. Conclusion: Endoscopic lobectomy of thyroid is feasible and safe for single nodule or multinodules located in the same lobe. There may be 2 approaches anterior breast wall and auxiliary approach.