Endoscopic Thyroidectomy for Thyroid Malignancies: Comparison with Conventional Open Thyroidectomy

Chung, Yoo Seung; Choe, Jun Ho; Kang, Kyung Ho; Kim, Seok Won; Chung, Ki-Wook; Park, Kyoung Sik; Han, Wonshik; Noh, Dong‐Young; Oh, Seung Keun; Youn, Yeo-Kyu

doi:10.1007/s00268-007-9117-0

Cited by 187 publications

(161 citation statements)

References 29 publications

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“…Endoscopic thyroid operations can be classified based on the method of making the working space, the continuous CO 2 gas insufflation method, and the gasless method [3,5,7]. According to the insertion site of surgical instruments, endoscopic surgery can be sorted as cervical [3,6], anterior chest wall [7], breast [8], axillary [4,5,11], and axillarybreast approaches [14]. These various techniques of endoscopic thyroidectomy have their own advantages and pitfalls.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of endoscopic thyroidectomy versus conventional open thyroidectomy in papillary thyroid microcarcinoma (PTMC) patients

Jeong

Kang

Yun

et al. 2009

Journal of Surgical Oncology

132

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Background: The aim of this study was to evaluate and compare the early surgical outcomes of endoscopic and conventional open thyroidectomies in patients with papillary thyroid microcarcinoma (PTMC). Methods: Between September 2005 and December 2007, 499 patients with PTMC were enrolled. 275 patients underwent gasless endoscopic thyroidectomy via the axillary route (endo group), and 224 patients underwent conventional open thyroidectomy (open group). We analyzed the patient's clinico-pathologic characteristics and surgical completeness between the two groups. Results: The endo group was younger than the open group. The open group underwent more extensive surgery than the endo group. The operative time was longer in the endo group than the open group (138.5 AE 49.0 minvs. 105.5 AE 41.6 min; P < 0.0001), and a lesser number of lymph nodes were retrieved in the endo group compared to the open group (5.05 AE 2.94 vs. 5.96 AE 4.50, P ¼ 0.007). We experienced complications in the endo group, such as transient hypocalcemia, transient RLN palsies, tracheal injuries, and esophageal injuries. Therewas no abnormal uptake on RAI scans in the two groups. From among patients who had undergone total thyroidectomy, all patients in the endo group had <1 ng/ml of serum Tg post-operatively; the seven patients in the open group had >1 ng/ml of serum Tg post-operatively. Tumor recurrence was detected in the open group only (n ¼ 6). Also we checked the post-operative Tg in patients who had undergone lobectomy in the two groups, and found that there were no statistical differences in the two groups. Conclusions: According to our experience, gasless endoscopic thyroidectomy using a trans-axillary approach is a safe and feasible alternative to conventional open thyroidectomy in selected patients with PTMC.

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Section: Discussionmentioning

confidence: 99%

Comparative study of endoscopic thyroidectomy versus conventional open thyroidectomy in papillary thyroid microcarcinoma (PTMC) patients

Jeong

Kang

Yun

et al. 2009

Journal of Surgical Oncology

132

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“…Since then, various methods including axillary, breast, and anterior chest approaches have been introduced by many surgeons. The use of endoscopic for complete thyroidectomy has been viewed with concern, although many surgeons have regarded benign thyroid disease as an indication for endoscopic surgery [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Right Lobectomy Axillary-breast Approach: Report of Two Cases

Irawati¹

2010

WJOLS

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Background. We reported our two initial experiences in the treatment of thyroid disease with endoscopic thyroidectomy. Minimally invasive video-assisted technique (MIVAT) was initially introduced by Miccoli. The modification was made by using axillary and breast technique. Method. Two young women patients, with 4 and 5 cm right lobe thyroid disease suspected to be benign. From physical examination, sonography, and FNAB findings, the two cases were categorized as benign. We performed endoscopic right lobectomy through incision of 5-10 mm on axillary line and breast using CO2 insufflation. Result. Duration of first operation was 300 minutes and the second one was 120 minutes, with minimal blood loss and no major complication. Patients were discharged 24 hours after operation. Cosmetic result was excellent. Postoperative complications were shoulder discomfort and neck swelling. Conclusion. We reported two cases of endoscopic right lobectomy as a safe, reproducible technique with an indication in a minority of patients candidates for thyroidectomy and is characterized by less postoperative discomfort.

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“…Endoscopic thyroidectomy has several advantages over conventional thyroidectomy [4][5][6][7][8]. However, endoscopic thyroidectomy is a difficult technique for surgeons because of difficulties with adequate visualization and precise manipulation of the surgical field.…”

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confidence: 99%

Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy

et al. 2010

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Background Robotic thyroidectomy using a gasless transaxillary approach, first described in 2008, has become popular. This study compared outcomes, including postoperative distress and patient satisfaction, for patients undergoing robotic thyroidectomy with those for patients treated by conventional open thyroidectomy. Methods Of 84 prospectively enrolled patients, 41 underwent robotic thyroidectomy (the robot group), and 43 received conventional open thyroidectomy (the open group). All the patients were followed up for at least 3 months after surgery. Videolaryngostroboscopic examinations were performed preoperatively and after 1 week and after 3 months postoperatively. Postoperative pain and discomfort were evaluated using a symptom scale. Subjective voice and swallowing changes were assessed by questionnaires; and satisfaction with cosmetic outcome was measured by verbal response at 3 months. Results The two groups were similar in age, gender, type of operation, and final pathologic diagnosis. Although the mean operating time was significantly longer with the robotic technique than with open surgery, there were no betweengroup differences in postoperative pain or duration of hospital stay. No patient in either group experienced any major postoperative complication. Postoperative discomfort in the neck and swallowing disturbances were significantly more frequent in the open group than in the robot group, both at 1 week and at 3 months after surgery. However, there was no significant between-group difference in subjective voice parameters. At 3 months, the mean cosmetic satisfaction score was significantly higher in the robotic than in the open group. Conclusion Although postoperative pain levels and complications were comparable in the two groups, conventional open thyroidectomy requires a shorter operative time. The robotic technique, however, offers several distinct advantages including very good to excellent cosmetic results, reduced postoperative neck discomfort, and fewer adverse swallowing symptoms.Keywords Comparative study Á Cosmetic result Á Postoperative neck discomfort Á Robotic thyroidectomy Á Swallowing symptom Most patients with thyroid tumors are effectively treated surgically by practitioners experienced in the techniques of thyroidectomy. Many patients, especially women, undergoing thyroid surgery are concerned about the postoperative cosmetic appearance of the neck. Neck surgery also may result in postoperative discomfort, with pain, hyperesthesia, and paresthesia [1][2][3].

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Endoscopic Thyroidectomy for Thyroid Malignancies: Comparison with Conventional Open Thyroidectomy

Cited by 187 publications

References 29 publications

Comparative study of endoscopic thyroidectomy versus conventional open thyroidectomy in papillary thyroid microcarcinoma (PTMC) patients

Comparative study of endoscopic thyroidectomy versus conventional open thyroidectomy in papillary thyroid microcarcinoma (PTMC) patients

Endoscopic Right Lobectomy Axillary-breast Approach: Report of Two Cases

Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy

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