title: Endoscopic thyroidectomy via breast approach for patients with Graves' disease.
abstract: BACKGROUND
  Endoscopic thyroidectomy via breast approach provides excellent results from a cosmetic viewpoint. We applied this procedure to Graves' disease and evaluated its feasibility and outcomes.
  
  
  METHODS
  From May 2006 to November 2009, a total of 37 patients (34 women and 3 men) with Graves' disease were included in this study. Bilateral subtotal thyroidectomy, which left behind 4-6 g of thyroid remnant, was the standard procedure. For markedly enlarged goiter, fractional resection was performed.
  
  
  RESULTS
  This procedure was performed successfully in all 37 patients. The mean operative time, mean blood loss, and mean excised thyroid weight were 84.7 min, 64 ml, and 51.8 g, respectively. Fractional resection was performed in six cases, where the mean operative time, mean blood loss, and mean excised thyroid weight were 119 min, 138.3 ml, and 102.2 g, respectively. Postoperative transient hypocalcemia occurred in 5 cases (13.5%), and no other complications were noted. The average postoperative hospital stay was 3.4 (range, 3-5) days. One case experienced recurrent hyperthyroidism during a mean follow-up period of 13 months. All patients were satisfied with the cosmetic result of the procedure.
  
  
  CONCLUSIONS
  Endoscopic subtotal thyroidectomy performed via breast approach is a technically feasible and safe procedure with excellent cosmetic results for patients with Graves' disease. In patients with markedly enlarged thyroid glands, subtotal thyroidectomy can be achieved through a fractional resection strategy.
authors.affiliation: Department of General Surgery, Second Affiliated Hospital, Zhejiang University, Hangzhou 310009, China. yugehdh@163.com
authors.forename: Zhi Yu
authors.initials: ZY
authors.lastname: Li
authors.forename: Ping
authors.initials: P
authors.lastname: Wang
authors.forename: Yong
authors.initials: Y
authors.lastname: Wang
authors.forename: Shao Ming
authors.initials: SM
authors.lastname: Xu
authors.forename: Li Ping
authors.initials: LP
authors.lastname: Cao
authors.forename: Ri Shen
authors.initials: RS
authors.lastname: Que
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001940:Breast; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006111:Graves Disease / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013965:Thyroidectomy / Q000379:methods*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D055815:Young Adult
chemical_list: D013972:Thyrotropin; D013974:Thyroxine