title: Comparative study of endoscopic thyroidectomy versus conventional open thyroidectomy in papillary thyroid microcarcinoma (PTMC) patients.
abstract: BACKGROUND
  The aim of this study was to evaluate and compare the early surgical outcomes of endoscopic and conventional open thyroidectomies in patients with papillary thyroid microcarcinoma (PTMC).
  
  
  METHODS
  Between September 2005 and December 2007, 499 patients with PTMC were enrolled. 275 patients underwent gasless endoscopic thyroidectomy via the axillary route (endo group), and 224 patients underwent conventional open thyroidectomy (open group). We analyzed the patient's clinico-pathologic characteristics and surgical completeness between the two groups.
  
  
  RESULTS
  The endo group was younger than the open group. The open group underwent more extensive surgery than the endo group. The operative time was longer in the endo group than the open group (138.5 +/- 49.0 min vs. 105.5 +/- 41.6 min; P < 0.0001), and a lesser number of lymph nodes were retrieved in the endo group compared to the open group (5.05 +/- 2.94 vs. 5.96 +/- 4.50, P = 0.007). We experienced complications in the endo group, such as transient hypocalcemia, transient RLN palsies, tracheal injuries, and esophageal injuries. There was no abnormal uptake on RAI scans in the two groups. From among patients who had undergone total thyroidectomy, all patients in the endo group had <1 ng/ml of serum Tg post-operatively; the seven patients in the open group had >1 ng/ml of serum Tg post-operatively. Tumor recurrence was detected in the open group only (n = 6). Also we checked the post-operative Tg in patients who had undergone lobectomy in the two groups, and found that there were no statistical differences in the two groups.
  
  
  CONCLUSIONS
  According to our experience, gasless endoscopic thyroidectomy using a trans-axillary approach is a safe and feasible alternative to conventional open thyroidectomy in selected patients with PTMC.
authors: Department of Surgery, Yonsei University College of Medicine, Seodaemun-gu, Seoul, South Korea.
authors: Jong Ju
authors: JJ
authors: Jeong
authors: Sang-Wook
authors: SW
authors: Kang
authors: Ji-Sup
authors: JS
authors: Yun
authors: Tae Yon
authors: TY
authors: Sung
authors: Seung Chul
authors: SC
authors: Lee
authors: Yong Sang
authors: YS
authors: Lee
authors: Kee-Hyun
authors: KH
authors: Nam
authors: Hang Seok
authors: HS
authors: Chang
authors: Woong Youn
authors: WY
authors: Chung
authors: Cheong Soo
authors: CS
authors: Park
mesh_terms: D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D013954:Thyroglobulin / Q000097:blood; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D013997:Time Factors
chemical_list: D013954:Thyroglobulin