[Indications for and limitations of endoscopic thyroid surgery]

Area of Science:

• Minimally Invasive Surgery
• Endocrine Surgery
• Surgical Oncology

Background:

• Endoscopic thyroid surgery is increasingly favored for cosmetic outcomes.
• Common methods for creating surgical space include CO2 insufflation and skin lifting.
• Various incision sites are utilized, including chest wall, axillary, and submandibular areas.

Purpose of the Study:

• To evaluate the clinical outcomes and utility of the original video-assisted neck surgery (VANS) method.
• To compare operative time and blood loss between small and large thyroid tumors using VANS.
• To assess the safety and cosmetic benefits of VANS for thyroid tumor removal.

Main Methods:

• The study analyzed over 180 cases using the VANS endoscopic technique.
• 161 patients with benign thyroid tumors were divided into small (<5 cm) and large (>=5 cm) groups for comparison.
• Procedures included near/subtotal lobectomy for benign tumors and total lobectomy with lymph node clearance for malignant cases.

Main Results:

• VANS was used for over 60% of benign and 7.1% of malignant thyroid tumors.
• Larger tumors required statistically longer operating times and resulted in greater blood loss.
• Tumors up to 7.4 cm were safely removed with increasing surgical experience.

Conclusions:

• The VANS method is a feasible, practical, and safe endoscopic approach for thyroid surgery, offering significant cosmetic advantages.
• While effective for benign and small malignant thyroid tumors, the primary surgical goal must not be compromised.
• Careful patient selection and adequate surgeon training are essential for optimal VANS outcomes.