title: Endoscopic thyroid surgery through the axillo-bilateral-breast approach.
abstract: We developed a new endoscopic thyroid surgery by the axillo-bilateral-breast approach (ABBA) method, which is different from the previously described breast approach (BA) in that the port sites are modified to obtain a better view and to prevent the interference of surgical instruments. This modification also improves cosmetic results by eliminating the parasternal incision, which results in hypertrophic scar in a significant number of cases treated with BA. Twelve patients with benign thyroid tumors successfully underwent endoscopic thyroid surgery by ABBA, and their clinical outcomes were compared with those of four patients treated with BA. The mean operation time was significantly shorter in the ABBA group than in the BA group (188 minutes vs. 270 minutes; P < 0.01). Furthermore, the mean blood loss in the ABBA group (53 mL) was half of that in the BA group (108 mL). Neither conversion to open surgery nor significant intraoperative complications were experienced. The operative scars by ABBA became inconspicuous in a few weeks. These results seem to indicate that ABBA is a better method than BA and can be a feasible option, particularly for young patients who opt for the better cosmetic outcome.
authors.affiliation: Department of Surgical Oncology, Graduate School of Medicine, Osaka University, Suita, Japan.
authors.forename: Kenzo
authors.initials: K
authors.lastname: Shimazu
authors.forename: Eiichi
authors.initials: E
authors.lastname: Shiba
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tamaki
authors.forename: Shuji
authors.initials: S
authors.lastname: Takiguchi
authors.forename: Eiji
authors.initials: E
authors.lastname: Taniguchi
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ohashi
authors.forename: Shinzaburo
authors.initials: S
authors.lastname: Noguchi
mesh_terms: D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D001365:Axilla / Q000473:pathology / Q000601:surgery*; D001940:Breast / Q000473:pathology / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*