title: Endoscopic thyroidectomy by the breast approach: a single institution's 9-year experience.
abstract: BACKGROUND
  The aim of this study was to evaluate the feasibility and cosmetic results of endoscopic thyroidectomy by the breast approach for patients with thyroid diseases.
  
  
  METHODS
  From August 1998 to July 2007, 92 patients with benign thyroid diseases underwent endoscopic thyroidectomy at our institution. Of these patients, 54 underwent thyroid lobectomy for a thyroid nodule, and 38 selected subtotal thyroidectomy for Graves' disease.
  
  
  RESULTS
  Ninety of the 92 procedures were successfully completed endoscopically. Mean operative time for thyroid lobectomy and subtotal thyroidectomy was 121.1 min and 231.9 min, respectively. Postoperative complications included one wound infection, one transient and one permanent recurrent laryngeal nerve palsy, one transient hypocalcemia, and five hypertrophic scars in the right breast medial margin. At 84 months of follow-up, one patient reported paresthesia in the anterior chest and one had experienced swallowing discomfort. Patient satisfaction was recorded as "satisfied," "equivocal," and "unsatisfied" in 54, 2, and 0 patients. Mean satisfaction score was 9.7, 9.5, 9.5, and 8.9 points in patients in their teens, 20s, 30s, and 40s, respectively, with an overall mean score of 9.3 points, showing more satisfaction in the young.
  
  
  CONCLUSIONS
  Endoscopic thyroidectomy by the breast approach for patients with thyroid diseases is an effective procedure that allows an excellent cosmetic result.
authors.affiliation: Department of Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, Japan. sakira@iwate-med.ac.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Sasaki
authors.forename: Jun
authors.initials: J
authors.lastname: Nakajima
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Ikeda
authors.forename: Koki
authors.initials: K
authors.lastname: Otsuka
authors.forename: Keisuke
authors.initials: K
authors.lastname: Koeda
authors.forename: Go
authors.initials: G
authors.lastname: Wakabayashi
mesh_terms: D000328:Adult; D001940:Breast; D004724:Endoscopy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011183:Postoperative Complications; D011795:Surveys and Questionnaires; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D013997:Time Factors