Endoscopic thyroid surgery via a breast approach: a single institution's experiences

Area of Science:

• Endocrinology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Increasing incidence of thyroid carcinoma in young women necessitates cosmetic considerations in thyroid surgery.
• Endoscopic thyroid surgery approaches are evolving, with expanded applications.
• The breast approach for endoscopic thyroidectomy has been utilized since 1999.

Purpose of the Study:

• To evaluate the safety and outcomes of endoscopic thyroidectomy via a breast approach.
• To assess the feasibility of this technique for differentiated thyroid carcinoma.
• To identify potential complications associated with the procedure.

Main Methods:

• A retrospective analysis of 452 patients undergoing endoscopic thyroidectomy via a breast approach between 1999 and 2012.
• Inclusion criteria: benign tumors <4 cm, malignant nodules <2 cm, no lymph node metastasis or local invasion.
• Analysis of clinicopathologic data and surgical factors.

Main Results:

• The study included 452 patients with a mean age of 38.4 years.
• Final pathologies included papillary carcinoma (n=120), follicular carcinoma (n=8), nodular hyperplasia (n=266), and adenomas.
• Complications included temporary hypoparathyroidism (7.1%), permanent hypoparathyroidism (0.9%), and transient vocal cord paresis (4.4%).

Conclusions:

• Endoscopic thyroidectomy via a breast approach is a safe and feasible minimally invasive method.
• The technique is suitable for patients with benign and low-risk differentiated thyroid disease.
• The procedure is associated with minimal complications, offering a cosmetic advantage.