Outcome Comparison between Endoscopic Transoral and Bilateral Axillo-Breast Approach Thyroidectomy Performed by a...

Area of Science:

• Endocrinology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• The transoral and bilateral axillo-breast approach (BABA) are remote access methods for endoscopic thyroidectomy.
• Both techniques utilize CO2 insufflation for workspace maintenance.
• Literature comparing outcomes between these endoscopic thyroidectomy approaches is limited.

Purpose of the Study:

• To compare the peri-operative outcomes of endoscopic transoral thyroidectomy versus the bilateral axillo-breast approach (BABA).
• To evaluate operative time, blood loss, drainage, hospital stay, pain, lymph node retrieval, and complications.
• To provide data for patient selection based on technique.

Main Methods:

• Retrospective review of 72 transoral and 63 BABA endoscopic thyroidectomies performed by a single surgeon.
• Data collected included operative time, blood loss, drainage volume, hospital stay, pain scores, lymph nodes retrieved, and complications.
• Statistical comparison of peri-operative parameters between the two groups.

Main Results:

• Transoral patients were younger with smaller tumors; operative times were initially longer but normalized with experience.
• Lower postoperative drainage was observed in the transoral group (64.9 ml vs. 78.5 ml).
• No significant differences were found in blood loss, hospital stay, pain, lymph node yield, or complication rates (hypoparathyroidism, vocal cord palsy).

Conclusions:

• Endoscopic transoral thyroidectomy and BABA demonstrate comparable surgical outcomes.
• Both approaches are viable options for endoscopic thyroidectomy.
• Patient preference can be a deciding factor when selecting between transoral and BABA techniques.