[Endoscopic thyroidectomy via the areola of breast approach].
OBJECTIVE
To investigate the feasibility and safety of endoscopic thyroidectomy via the areola of breast approach.


METHODS
Between April 2005 to September 2008, endoscopic thyroidectomy via the areola of breast approach was performed in 28 female patients. Of the patients, 25 cases presented with nodular goiter, 2 cases with Grave's disease and 1 case with minimum papillary carcinoma. The average age was 22.5 years (range, 18-38 years). A 10 mm trocar was placed on the medial border of the areola of the right breast for the video-endoscopy and removing specimens, and a 5 mm trocar was placed on the lateral border of the areola of the same breast as the assisted operation hole. Another 5 mm trocar was placed on the medial border of the areola of left breast as the main operation hole. The operation data was recorded and analyzed.


RESULTS
All the 28 operations were successful. The procedures included one lobe total thyroidectomy in 5 cases, one lobe subtotal thyroidectomy in 15 cases, subtotal thyroidectomy in 3 cases, one lobe near total thyroidectomy + the other lobe subtotal thyroidectomy in 4 cases, and one lobe total thyroidectomy + the central group lymph node resection + the other lobe subtotal thyroidectomy in 1 case. The average operation time was 60.7 minutes (range, 40-125 minutes), the average operation blood loss was 5.8 ml (range, 2-15 ml), the average length of post-operative hospital stay was 3.1 days (range, 2-5 days). No adverse effects was found after the operation, such as damage to the parathyroid gland and the laryngeal nerve. The patients were followed-up for 1 to 40 months with satisfactory results. All 28 patients were satisfied with the cosmetic effects of the operation.


CONCLUSIONS
Endoscopic thyroidectomy via the areola of breast approach produces an outstanding cosmetic effect, it is safe and feasible.
Department of General Surgery, First Affiliated Hospital of Jinan University, Guangzhou 510630, China. wangcunchuan@tom.com
Cun-chuan
CC
Wang
You-zhu
YZ
Hu
Zhen-wu
ZW
Lai
Jing-ge
JG
Yang
Jun
J
Chen
Yun-long
YL
Pan
Peng
P
Xu
Jin-yi
JY
Li
D000293:Adolescent; D000328:Adult; D001940:Breast / Q000601:surgery; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult