[Endoscopic surgery by infraclavicular approach for larger benign thyroid tumors]

To investigate the endoscopic surgical efficacy of larger benign thyroid tumors and to evaluate its feasibility and safety.

Forty-two patients with benign thyroid tumors underwent endoscopic surgery by infraclavicular approach (a 4 - 6 cm incision on larger side of the tumor ≥ 3 cm off midline) at our hospital between April 2005 and January 2010. Fifty-four patients were enrolled as controls by conventional approach. Two groups were compared with regards to tumor size, surgical approach, complications, operative duration, hospital stay and incision cosmetic outcomes.

Two groups were matched by age, sex and tumor size. No statistical significance was found in surgical approach. Pathology examinations proved benign in both groups. The cosmetic results in endoscopic group were obviously favorable than those in conventional group (1.6 ± 0.9 vs 5.8 ± 1.2, Z = 8.418, P = 0.000). All patients were followed up for a period of 6 months to 4 years. Endoscopic group: no permanent glottic paralysis; one patient appeared hypocalcemic and recovered in 1 week; two patients presented with skin tension and alleviated in 3 months; two patients occurred temporary glottic paralysis and recovered in 1 month. Conventional group: no permanent glottic paralysis; three patients appeared temporarily hypocalcemic; no dyspnea from airway collapse; no recurrence. There was no significant distinction between two groups (χ(2) = 1.247, P = 0.459).

Endoscopic surgery by infraclavicular approach is suitable for patients with ≥ 4 cm thyroid tumors.