Abstract
Background
By comparison with the conventional surgical approach to thyroidectomy, scarless (in the neck) endoscopic thyroidectomy (SET) has a superior cosmetic result but a very long learning curve. The objective of the present study was to compare surgical outcomes of SET performed by an experienced surgeon with the outcomes of conventional thyroidectomy.
Method
Enrolled in this study were 25 patients who underwent SET and 18 who underwent conventional surgery. Differences in size of tumor, length of incision, duration of operation, volume of blood loss, pathological findings, postoperative pain, complications, and cosmetic result were investigated.
Results
The two groups were well matched. The total length of incisions and volume of blood loss of SET were significantly lower than those of conventional surgery. In addition to the superior cosmetic result, postoperative pain was significantly less severe and rates of hypesthesia or paresthesia and discomfort while swallowing were significantly lower in the endoscopy group.
Conclusions
In experienced hands, SET offers more benefits than the conventional approach, including less postoperative pain and discomfort and a better cosmetic outcome.
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References
Tan CT, Cheah WK, Delbridge L (2008) “Scarless” (in the neck) endoscopic thyroidectomy (SET): an evidence-based review of published techniques. World J Surg 32:1349–1357
Gagner M (1996) Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg 83:875
Ikeda Y, Takami H, Sasaki Y et al (2000) Endoscopic neck surgery by the axillary approach. J Am Coll Surg 191:336–340
Ohgami M, Ishii S, Arisawa Y et al (2000) Scarless endoscopic thyroidectomy: breast approach for better cosmesis. Surg Laparosc Endosc Percutan Tech 10:1–4
Ikeda Y, Takami H, Sasaki Y et al (2002) Comparative study of thyroidectomies. Endoscopic surgery versus conventional open surgery. Surg Endosc 16:1741–1745
Sasaki A, Nakajima J, Ikeda K et al (2008) Endoscopic thyroidectomy by the breast approach: a single institution’s 9-year experience. World J Surg 32:381–385
Liu S, Qiu M, Jiang DZ et al (2009) The learning curve for endoscopic thyroidectomy: a single surgeon’s experience. Surg Endosc 23:1802–1806
Slotema ET, Sebag F, Henry JF (2008) What is the evidence for endoscopic thyroidectomy in the management of benign thyroid disease? World J Surg 2:1325–1332
Wang M, Zhang T, Mao Z et al (2009) Effect of endoscopic thyroidectomy via anterior chest wall approach on treatment of benign thyroid tumors. J Laparoendosc Adv Surg Tech A 19:149–152
Ikeda Y, Takami H, Sasaki Y et al (2003) Clinical benefits in endoscopic thyroidectomy by the axillary approach. J Am Coll Surg 196:189–195
Shimizu K, Kitagawa W, Akasu H et al (2002) Video-assisted minimally invasive endoscopic thyroid surgery using a gasless neck skin lifting method—153 cases of benign thyroid tumors and applicability for large tumors. Biomed Pharmacother 56(Suppl 1):88s–91s
Perigli G, Cortesini C, Qirici E et al (2008) Clinical benefits of minimally invasive techniques in thyroid surgery. World J Surg 32:45–50
Kataoka H, Kitano H, Takeuchi E et al (2002) Total video endoscopic thyroidectomy via the anterior chest approach using the cervical region-lifting method. Biomed Pharmacother 56(Suppl 1):68s–71s
Koh YW, Kim JW, Lee SW et al (2009) Endoscopic thyroidectomy via a unilateral axillo-breast approach without gas insufflation for unilateral benign thyroid lesions. Surg Endosc 23:2053–2060
Ikeda Y, Takami H, Sasaki Y et al (2004) Are there significant benefits of minimally invasive endoscopic thyroidectomy? World J Surg 28:1075–1078
Shimizu K, Tanaka S (2003) Asian perspective on endoscopic thyroidectomy—a review of 193 cases. Asian J Surg 26:92–100
Cho YU, Park IJ, Choi KH et al (2007) Gasless endoscopic thyroidectomy via an anterior chest wall approach using a flap-lifting system. Yonsei Med J 48:480–487
Duncan TD, Rashid Q, Speights F et al (2007) Endoscopic transaxillary approach to the thyroid gland: our early experience. Surg Endosc 21:2166–2171
Abu-Hijleh MF, Roshier AL, Al-Shboul Q et al (2006) The membranous layer of superficial fascia: evidence for its widespread distribution in the body. Surg Radiol Anat 28:606–619
Ishibashi S, Takeuchi H, Fujii K et al (2006) Length of laparotomy incision and surgical stress assessed by serum IL-6 level. Injury 37:247–251
Huang TJ, Hsu RW, Li YY et al (2005) Less systemic cytokine response in patients following microendoscopic versus open lumbar discectomy. J Orthop Res 23:406–411
Schietroma M, Carlei F, Franchi L et al (2004) A comparison of serum interleukin-6 concentrations in patients treated by cholecystectomy via laparotomy or laparoscopy. Hepatogastroenterology 51:1595–1599
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Zhi-guo Jiang and Wei Zhang contributed equally to this work.
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Jiang, Zg., Zhang, W., Jiang, Dz. et al. Clinical Benefits of Scarless Endoscopic Thyroidectomy: An Expert’s Experience. World J Surg 35, 553–557 (2011). https://doi.org/10.1007/s00268-010-0905-6
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DOI: https://doi.org/10.1007/s00268-010-0905-6