title: Clinical benefits in endoscopic thyroidectomy by the axillary approach.
abstract: BACKGROUND
  Surgical treatments for thyroid diseases require skin incisions that can result in prominent scars, complaints resulting from adhesions, hypesthesia, and paresthesia in the neck. We have developed an endoscopic thyroidectomy using an axillary approach. In this article, we compare our original technique with conventional open surgery from the aspects of surgical invasiveness and patients' complaints after surgery.
  
  
  METHODS
  Each procedure was performed in 20 patients with follicular tumors. The two groups were similar for age, gender, and the mean diameter of the thyroid tumor. No statistically significant difference in the final pathological diagnosis was found between the two groups. Surgical invasiveness and patients' complaints after surgery were compared using results of the operation and a questionnaire.
  
  
  RESULTS
  The operating time for open surgery was significantly shorter than that for endoscopic surgery (p < 0.01). In the endoscopic surgery group, the patient questionnaires revealed that 4 patients had severe anterior chest pain on the first postoperative day. The postoperative pain decreased after, and we could not find any difference between the two groups with regard to postoperative pain. Three months after surgery, one patient who had received an endoscopic procedure complained of slight hypesthesia, and none of the patients complained of discomfort while swallowing. Among the patients who underwent open surgery, 13 patients (65%; p < 0.01) complained of hypesthesia or paresthesia and 6 patients (30%; p < 0.05) complained of discomfort while swallowing. All of the patients treated using the endoscopic procedure were satisfied with the cosmetic results, but 15 patients who underwent open surgery complained of unsatisfactory cosmetic results (p < 0.01).
  
  
  CONCLUSIONS
  The incidence of postoperative complaints after endoscopic surgery is considerably lower than that after open surgery.
authors.affiliation: Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takami
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Sasaki
authors.forename: Junichi
authors.initials: J
authors.lastname: Takayama
authors.forename: Masanori
authors.initials: M
authors.lastname: Niimi
authors.forename: Shigenao
authors.initials: S
authors.lastname: Kan
mesh_terms: D000328:Adult; D001365:Axilla; D002921:Cicatrix / Q000209:etiology; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D013959:Thyroid Diseases / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome