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Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
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Endoscopic thyroidectomy: the development in a Chinese center.

Bo Chen1, Yanlei Wang, Shijin Xuan

  • 1Department of General Surgery, Qilu Hospital of Shandong University, Jinan, China.

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|November 3, 2011
PubMed
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Endoscopic thyroidectomy (ET) offers superior cosmesis and decreased invasiveness compared to open procedures. This minimally invasive technique is readily learned by competent surgeons, with a high success rate in selected patients.

Area of Science:

  • Minimally Invasive Surgery
  • Endocrine Surgery
  • Surgical Oncology

Background:

  • Endoscopic thyroidectomy (ET) avoids the significant cervical incision of traditional open surgery.
  • Understanding the nuances of ET, including its limitations and advantages, is crucial for effective application.
  • This report details the development and outcomes of an ET center in China.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of endoscopic thyroidectomy (ET) in a Chinese population.
  • To assess the safety and efficacy of different endoscopic approaches for thyroidectomy.
  • To analyze the learning curve and potential complications associated with ET.

Main Methods:

  • A retrospective review of 235 patients who underwent attempted ET between 2001 and 2010.

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  • Procedures were performed using either a modified anterior chest or a breast endoscopic approach.
  • Patient data, including surgical outcomes, complications, and follow-up, were analyzed.

    • Main Results:

    • ET was successfully completed in 228 out of 235 patients (97%).
    • The modified anterior chest approach was used in 63.6% and the breast approach in 36.4% of cases.
    • Low postoperative pain scores were reported, with minor complications including emphysema, seromas, and transient nerve palsies. Seven conversions to open surgery occurred due to malignancy or large tumor size.

    Conclusions:

    • Endoscopic thyroidectomy (ET) is a safe and effective procedure when performed by surgeons proficient in both laparoscopic techniques and open thyroidectomy.
    • ET provides significant cosmetic benefits and reduced invasiveness.
    • Careful patient selection, particularly regarding tumor size and type, is essential for successful ET outcomes.