title: Endoscopic thyroidectomy via an axillo-breast approach without gas insufflation for benign thyroid nodules and micropapillary carcinomas: preliminary results.
abstract: OBJECTIVE
  To examine the feasibility of endoscopic thyroidectomy (ET) via an axillo- breast approach without gas insufflation for large thyroid tumors and micropapillary carcinomas.
  
  
  METHODS
  The patients in the benign group were separated into groups 1 (n=95, <4 cm in tumor diameter) and 2 (n=37, ≥4 cm in tumor diameter). Also, 57 patients in the micropapillary carcinoma group underwent an endoscopic hemithyroidectomy (HT) (group 3) and were compared with 60 patients who received conventional open HT (group 4). Postoperative functional outcome, local complications, surgical outcomes, and pathological outcomes were compared between the groups.
  
  
  RESULTS
  In the benign group, there was no significant difference in mean operating time, hospital stay, or overall perioperative complications between the two groups. In the micropapillary carcinoma group, mean operating time and hospital stay in group 3 were significantly longer than in group 4 (p=0.015 and p≤0.001). The overall perioperative complications did not differ significantly between the groups. The postoperative cosmetic result was better in groups 1-3 (endo group) than in group 4 (open group).
  
  
  CONCLUSIONS
  ET via a gasless axillo-breast approach seems to be a safe procedure even for benign thyroid lesions ≥4 cm and micropapillary carcinomas. Although it has the advantage of better cosmetic results over open thyroidectomy, there is room for improvement in terms of lessening its invasiveness and shortening the operative time.
authors.affiliation: Department of Otorhinolaryngology, Yonsei University College of Medicine, 250 Seongsan-ro, Seodaemun-gu, Seoul 120-752, Korea.
authors.forename: Hyun Jun
authors.initials: HJ
authors.lastname: Hong
authors.forename: Won Shik
authors.initials: WS
authors.lastname: Kim
authors.forename: Yoon Woo
authors.initials: YW
authors.lastname: Koh
authors.forename: So Yoon
authors.initials: SY
authors.lastname: Lee
authors.forename: Yoo Seob
authors.initials: YS
authors.lastname: Shin
authors.forename: Yong Cheol
authors.initials: YC
authors.lastname: Koo
authors.forename: Yoon A
authors.initials: YA
authors.lastname: Park
authors.forename: Eun Chang
authors.initials: EC
authors.lastname: Choi
mesh_terms: D000328:Adult; D002291:Carcinoma, Papillary / Q000473:pathology / Q000601:surgery*; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016606:Thyroid Nodule / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome