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Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
Published on: September 15, 2023
The minimally-invasive thyroidectomy incision: a histological analysis
Waleed H Ezzat1, Brian J O'Hara, Kyle J Fisher
1Thomas Jefferson University, Department of Otolaryngology - Head and Neck Surgery, Philadelphia, PA 19107, USA.
Summary
Histologic analysis of minimally invasive thyroidectomy (MIT) incisions found no evidence that trimming skin edges improves healing. This study suggests routine trimming is not supported by current histological data for better cosmetic outcomes.
Area of Science:
- Surgical Oncology
- Dermatopathology
Background:
- Minimally invasive thyroidectomy (MIT) offers cosmetic benefits due to smaller incisions.
- However, surgical retraction can cause skin damage and impair wound healing.
- Trimming incision edges is proposed to enhance cosmesis, but lacks histological support.
Purpose of the Study:
- To investigate the histological effects of excising incision edges during MIT.
- To determine if this technique provides a histological basis for improved cosmetic outcomes.
Main Methods:
- Prospective observational study of nine patients undergoing MIT.
- Excision and histological analysis (hematoxylin and eosin staining) of superior and inferior skin edges.
- Pathologist evaluation for dermal architecture, inflammation, edema, hemorrhage, and vascular changes.
Main Results:
- No significant histological findings like dermal damage, inflammation, edema, or hemorrhage were observed.
- Focal blood vessel ectasia was noted in three of the nine specimens.
- The study found no histological evidence supporting routine trimming of MIT incisions.
Conclusions:
- Current histological findings do not support the routine trimming of incision edges during MIT.
- Further research is needed to assess the long-term cosmetic results of MIT incisions.
- The study highlights the need for evidence-based practices in surgical wound management.
