The online version of this article (doi:10.1186/1477-7819-10-269) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interest.
H Lee drafted the manuscript. J lee was responsible for analysis and interpretation of data. KY Sung supervised the research, the revision of the manuscript and was the corresponding author. All authors read and approved the final manuscript.
Endoscopic thyroidectomy has been applied prudently to malignant thyroid tumors. The purpose of our study was to compare the surgical outcomes of endoscopic thyroidectomy (ET) and conventional open thyroidectomy (COT) for micropapillary thyroid carcinoma.
From October 2002 to December 2008, 78 patients underwent unilateral lobectomy and isthmectomy with central lymph node dissection for papillary thyroid microcarcinoma. Of these, 37 patients underwent ET and 41patients COT. Surgical outcomes, including operation time, number of retrieved lymph nodes, postoperative complication rate and patients’ satisfaction with the cosmetic results, were analyzed.
The mean age of the patients was 42.3 ± 7.6 years in the ET group and 49.0 ± 10.8 years in the OT group (P = 0.003). The operation time was shorter in the COT group (112.3 ± 14min) than in the ET group (138.4 ± 36.9 min, P< 0.01). However, there were no significant differences in tumor size (0.5 ± 0.231vs. 0.41 ± 0.264cm, P = 0.116), number of retrieved lymph nodes (3.63 ± 2.1vs. 3.82 ± 3.28, P = 0.78) or postoperative hospital stay (3.35 ± 0.94vs. 3.17 ± 1.16 days, P = 0.457). Patients in the ET group experienced more pain than those in the COT group at 1 and 7 days after the operation as evaluated by a visual analog scale (P = 0.037, 0.026). Cosmetically, patients in the ET group were very satisfied with the operative procedure according to the questionnaire we used (1.43 ± 0.55vs. 3.21 ± 0.72, P< 0.001). The mean follow-up period was 54.3 months in the ET group and 47.4 months in the COT group, and each group exhibited one case of tumor recurrence detected at the other thyroid lobe within 2 years.
Large series of prospective studies and long-term follow-up are needed, but the results of ET using the axillary approach for micropapillary thyroid carcinoma were not inferiortothose using COT, and it might be a safe and feasible procedure with good cosmetic results.
Ohgami M, Ishii S, Arisawa Y, Ohmori T, Noga K, Furukawa T, Kitajima M: Scarless endoscopic thyroidectomy: breast approach for better cosmesis. Surg Laparosc Endosc Percutan Tech. 2000, 10: 1-4. PubMed
Cooper DS, Doherty GM, Haugen BR, Hauger BR, Kloos RT, Lee SL, Mandel SJ, Mazzaferri EL, McIver B, Pacini F, Schlumberger M, Sherman SI, Steward DL, Tuttle RM: Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009, 19: 1167-1214. 10.1089/thy.2009.0110. CrossRefPubMed
Hur SM, Kim SH, Lee SK, Kim WW, Choe J-H, Lee JE, Kim J-H, Nam S-J, Yang J-H, Kim JS: New endoscopic thyroidectomy with the bilateral areolar approach: a comparison with the bilateral axillo-breast approach. Surg Laparosc Endosc Percutan Tech. 2011, 21: e219-e224. 10.1097/SLE.0b013e3182239989. CrossRefPubMed
Gourin CG, Johson JT: Postoperative complication. Surgery of the Thyroid and Parathyroid Glands. Edited by: Randolph GW. 2002, Philadelphia: Saunders, 433-443. 1
Hong HJ, Kim WS, Koh YW, Lee SY, Shin YS, Koo YC, Park YA, Choi EC: Endoscopic thyroidectomy via axillo-breast approach without gas insufflations for benign thyroid nodules and micro papillary carcinomas: Preliminary results. Yonsei Med J. 2011, 52: 643-654. 10.3349/ymj.2011.52.4.643. PubMedCentralCrossRefPubMed
- Comparative study comparing endoscopic thyroidectomy using the axillary approach and open thyroidectomy for papillary thyroid microcarcinoma
Ki Young Sung
- BioMed Central
Neu im Fachgebiet Chirurgie
e.Med Kampagnen-Visual, Mail Icon II