Transaxillary gasless endoscopic hemithyroidectomy versus conventional open hemithyroidectomy: early single-centre...

Area of Science:

• Minimally Invasive Surgery
• Endocrine Surgery
• Surgical Education

Background:

• Conventional open thyroidectomy is the standard for thyroid disease.
• Endoscopic techniques offer improved visualization and cosmetic outcomes.
• Transaxillary hemithyroidectomy (TAH) is an emerging endoscopic approach.

Purpose of the Study:

• To compare conventional open hemithyroidectomy (COH) with endoscopic transaxillary hemithyroidectomy (TAH).
• To define the learning curve for the TAH procedure.
• To evaluate surgical outcomes and complication rates.

Main Methods:

• Retrospective analysis of 107 COH and 65 TAH cases.
• Comparison of demographic data and surgical results.
• Surgeon learning curve analysis using cumulative sum (CUSUM) for surgery duration.

Main Results:

• TAH was performed on younger females with smaller thyroid glands.
• TAH group had shorter hospital stays (p < 0.05).
• TAH surgery time was longer (78.1 min) than COH (66.7 min) (p < 0.05).
• Overall complication rates were similar; TAH showed a trend towards fewer unintentional parathyroidectomies.
• Surgery time for TAH was longer in patients with BMI > 30 (p = 0.004).
• CUSUM analysis indicated reduced surgery time after the 30th TAH case, with shortest times between 41-50 cases.

Conclusions:

• TAH results in longer surgery times but shorter hospital stays compared to COH.
• Postoperative complication rates are comparable between TAH and COH.
• Surgeons demonstrate proficiency in TAH after approximately 30 cases.
• Further matched-pair studies are needed to fully elucidate TAH outcomes.