Clinical analysis of total endoscopic thyroidectomy via breast areola approach in early differentiated thyroid cancer

The purpose of this study was to explore the efficacy and safety of total endoscopic thyroidectomy (TET) via breast areola approach in the treatment of early differentiated thyroid cancer.

The clinical data of 134 patients with early differentiated thyroid cancer were retrospectively analyzed. The patients underwent different treatments, including TET via breast areola approach in endoscope group (n=67), and conventional small incision open surgery in control group (n=67). The surgery-related indexes, complications, postoperative incision recovery, visual analogue scale (VAS) pain score, postoperative patients' satisfaction, tumor recurrence and survival conditions were compared between the two groups.

Compared with control group, the endoscope group showed significantly longer operation time, smaller intraoperative bleeding, less postoperative drainage, shorter duration of postoperative catheter indwelling and shorter postoperative length of stay. Meanwhile, in the endoscope group, the postoperative VAS pain score was markedly lower than that in control group, and the postoperative patients' satisfaction was higher than that in control group. The neurological severity score (NSS) had statistically significant differences between the two groups at 3 months and 6 months after operation. Moreover, no tumor recurrence and metastasis were found during the follow-up period.

TET via breast areola approach is safe and effective in the treatment of early differentiated thyroid cancer, and it can achieve a better cosmetic effect and high satisfaction of patients, which is worthy of clinical application.