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Three-dimensional versus two-dimensional endoscopic-assisted thyroidectomy via the anterior chest approach: a preliminary report

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Abstract

Objective

The objective of the study was to evaluate the safety and effectiveness of three-dimensional (3D) endoscopy for thyroidectomy and compare it to two-dimensional (2D) endoscopy. The major limitations of conventional endoscopy include its lack of depth perception and tactile feedback. The 3D endoscopy technique, which involves 3D imaging, is widely used. However, few reports have described the use of 3D endoscopic systems in thyroid surgery.

Method

In this single-institutional study, 103 consecutive patients who underwent endoscopic thyroidectomy between July 2013 and April 2014 were enrolled. Of these, 32 patients chose 3D endoscopy, and 71 patients chose 2D endoscopy and were used as a control group. All patients were stratified by type of operation.

Result

All 103 patients underwent a successful endoscopic-assisted thyroidectomy with no conversion to open surgery. There were no differences in operation time, intraoperative bleeding, postoperative drainage, the number of lymph nodes (LNs) dissected, major complications, and hospital stays. During a median follow-up of 28.0 months, no patients experienced a recurrence of thyroid cancer.

Conclusion

Our preliminary report demonstrates that 3D endoscopy achieved the same level of safety and effectiveness as 2D endoscopy in endoscopic-assisted thyroidectomies. Additionally, 3D endoscopy provided good depth perception and allowed the surgeon to easily recognize critical anatomical landmarks. Further large-scale studies, preferably prospective randomized control trials, are required to confirm this finding.

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References

  1. Miccoli P, Berti P, Raffaelli M, Conte M, Materazzi G, Galleri D (2001) Minimally invasive video-assisted thyroidectomy. Am J Surg 181(6):567–570

    Article  CAS  PubMed  Google Scholar 

  2. Storz P, Buess GF, Kunert W, Kirschniak A (2012) 3D HD vs. 2D HD: surgical task efficiency in standardised phantom tasks. Surg Endosc 26(5):1454–1460. doi:10.1007/s00464-011-2055-9

    Article  PubMed  Google Scholar 

  3. Bilgen K, Ustun M, Karakahya M, Isik S, Sengul S, Cetinkunar S, Kucukpinar TH (2013) Comparison of 3D imaging and 2D imaging for performance time of laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech 23(2):180–183. doi:10.1097/SLE.0b013e3182827e17

    Article  PubMed  Google Scholar 

  4. Velayutham V, Fuks D, Nomi T, Kawaguchi Y, Gayet B (2016) 3D visualization reduces operating time when compared to high-definition 2D in laparoscopic liver resection: a case-matched study. Surg Endosc 30(1):147–153. doi:10.1007/s00464-015-4174-1

    Article  PubMed  Google Scholar 

  5. Felisati G, Pipolo C, Maccari A, Cardia A, Revay M, Lasio GB (2013) Transnasal 3D endoscopic skull base surgery: questionnaire-based analysis of the learning curve in 52 procedures. Eur Arch Otorhinolaryngol 270(8):2249–2253. doi:10.1007/s00405-012-2328-5

    Article  CAS  PubMed  Google Scholar 

  6. Marcus HJ, Hughes-Hallett A, Cundy TP, Di Marco A, Pratt P, Nandi D, Darzi A, Yang GZ (2014) Comparative effectiveness of 3-dimensional vs. 2-dimensional and high-definition vs. standard-definition neuroendoscopy: a preclinical randomized crossover study. Neurosurgery 74 (4):375–380 (discussion 380–371). doi:10.1227/NEU.0000000000000249

    Article  PubMed  Google Scholar 

  7. Mercante G, Battaglia P, Manciocco V, Cristalli G, Pellini R, Spriano G (2013) Three-dimensional minimally invasive video-assisted thyroidectomy: preliminary report. J Exp Clin Cancer Res 32:78. doi:10.1186/1756-9966-32-78

    Article  PubMed  PubMed Central  Google Scholar 

  8. Chen J, Zheng H, He J (2015) 3D laparoscopic revision thyroidectomy through an anterior chest approach: a case report. J Laparoendosc Adv Surg Tech A 25(3):238–242. doi:10.1089/lap.2014.0653

    Article  PubMed  Google Scholar 

  9. Huang XM, Sun W, Zeng L, Liu X, Lu X, Xu YD, Zhang ZG, Xu G (2011) Gasless endoscopic thyroidectomy via an anterior chest approach: a review of 219 cases with benign tumor. World J Surg 35(6):1281–1286. doi:10.1007/s00268-011-1087-6

    Article  PubMed  Google Scholar 

  10. Cai Q, Huang XM, Sun W, Zheng YQ, Liang FY, Han P, Jiang XY (2012) Gasless video-assisted bilateral thyroidectomy by the anterior chest wall approach: 4 years of experience. Surg Laparosc Endosc Percutan Tech 22(3):255–259. doi:10.1097/SLE.0b013e3182508380

    Article  PubMed  Google Scholar 

  11. Cai Q, Huang X, Han P, Sun W, Liang F, Jiang X (2013) Endoscopy-assisted thyroid surgery via a subclavian approach. Surg Today 43(5):479–484. doi:10.1007/s00595-012-0327-1

    Article  PubMed  Google Scholar 

  12. Hong Y, Yu ST, Cai Q, Liang FY, Han P, Huang XM (2016) The experience of gasless endoscopic-assisted thyroidectomy via the anterior chest approach for Graves’ disease. Eur Arch Otorhinolaryngol 273(10):3401–3406. doi:10.1007/s00405-016-3971-z

    Article  PubMed  Google Scholar 

  13. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L (2016) 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 26(1):1–133. doi:10.1089/thy.2015.0020

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kunert W, Storz P, Kirschniak A (2013) For 3D laparoscopy: a step toward advanced surgical navigation: how to get maximum benefit from 3D vision. Surg Endosc 27(2):696–699. doi:10.1007/s00464-012-2468-0

    Article  PubMed  Google Scholar 

  15. Chai YJ, Suh H, Woo JW, Yu HW, Song RY, Kwon H, Lee KE (2016) Surgical safety and oncological completeness of robotic thyroidectomy for thyroid carcinoma larger than 2 cm. Surg Endosc 30:1–6. doi:10.1007/s00464-016-5097-1

    Article  Google Scholar 

  16. Lee SG, Lee J, Kim MJ, Choi JB, Kim TH, Ban EJ, Lee CR, Kang SW, Jeong JJ, Nam KH, Jo YS, Chung WY (2016) Long-term oncologic outcome of robotic vs. open total thyroidectomy in PTC: a case-matched retrospective study. Surg Endosc 30(8):3474–3479. doi:10.1007/s00464-015-4632-9

    Article  PubMed  Google Scholar 

  17. Song CM, Ji YB, Sung ES, Kim DS, Koo HR, Tae K (2016) Comparison of robotic vs. conventional selective neck dissection and total thyroidectomy for papillary thyroid carcinoma. Otolaryngol Head Neck Surg 154(6):1005–1013. doi:10.1177/0194599816638084

    Article  PubMed  Google Scholar 

  18. Cho MJ, Park KS, Cho MJ, Yoo YB, Yang JH (2015) A comparative analysis of endoscopic thyroidectomy vs. conventional thyroidectomy in clinically lymph node negative thyroid cancer. Ann Surg Treat Res 88(2):69–76. doi:10.4174/astr.2015.88.2.69

    Article  PubMed  PubMed Central  Google Scholar 

  19. Chung EJ, Park MW, Cho JG, Baek SK, Kwon SY, Woo JS, Jung KY (2015) A prospective 1-year comparative study of endoscopic thyroidectomy via a retroauricular approach vs. conventional open thyroidectomy at a single institution. Ann Surg Oncol 22(9):3014–3021. doi:10.1245/s10434-014-4361-7

    Article  PubMed  Google Scholar 

  20. Gao W, Liu L, Ye G, Lu W, Teng L (2015) Bilateral areolar approach endoscopic thyroidectomy for low-risk papillary thyroid carcinoma: a review of 137 cases [corrected]. Surg Laparosc Endosc Percutan Tech 25(1):19–22. doi:10.1097/SLE.0b013e3182a50f1f

    Article  PubMed  Google Scholar 

  21. Kim WW, Jung JH, Park HY (2015) A single surgeon’s experience and surgical outcomes of 300 robotic thyroid surgeries using a bilateral axillo-breast approach. J Surg Oncol 111(2):135–140. doi:10.1002/jso.23793

    Article  PubMed  Google Scholar 

  22. Tan Z, Gu J, Han Q, Wang W, Wang K, Ge M, Shang J (2015) Comparison of conventional open thyroidectomy and endoscopic thyroidectomy via breast approach for papillary thyroid carcinoma. Int J Endocrinol 2015:239610. doi:10.1155/2015/239610

    PubMed  PubMed Central  Google Scholar 

  23. Sorensen SM, Savran MM, Konge L, Bjerrum F (2016) Three-dimensional vs. two-dimensional vision in laparoscopy: a systematic review. Surg Endosc 30(1):11–23. doi:10.1007/s00464-015-4189-7

    Article  PubMed  Google Scholar 

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Acknowledgements

This study was supported by a research grant from the Sun Yat-sen University Clinical Research 5010 Program (Grant 2010008).

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    Authors and Affiliations

    1. Department of Otolaryngology, Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yan Jiang West Road, Guangzhou, 510120, Guangdong, China

      Shi-tong Yu, Ping Han, Faya Liang, Qian Cai, Peiliang Lin, Renhui Chen & Xiaoming Huang

    2. Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China

      Shi-tong Yu, Ping Han, Faya Liang, Qian Cai, Peiliang Lin, Renhui Chen & Xiaoming Huang

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    1. Shi-tong Yu
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    2. Ping Han
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    Correspondence to Xiaoming Huang.

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    Shi-tong Yu, Ping Han, Faya Liang, Qian Cai, Peiliang Lin, Renhui Chen, and Xiaoming Huang have no conflicts of interest or financial ties to disclose.

    Additional information

    Shi-tong Yu and Ping Han contributed equally to this work.

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    Yu, St., Han, P., Liang, F. et al. Three-dimensional versus two-dimensional endoscopic-assisted thyroidectomy via the anterior chest approach: a preliminary report. Surg Endosc 31, 4194–4200 (2017). https://doi.org/10.1007/s00464-017-5477-1

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