title: Endoscopic thyroidectomy: the development in a Chinese center.
abstract: BACKGROUND
  Endoscopic thyroidectomy (ET) precludes the long cervical incision of the open procedure. Although endoscopy is an essential tool taught to almost every surgeon, its effective use with regard to thyroidectomy requires understanding its limitations pertaining to trauma and cancer, as well as an understanding of the advantages and disadvantages of the different endoscopic approaches. The development of an ET center in China is discussed here.
  
  
  METHODS
  Overall, 235 patients who had undergone attempted ET in Qilu Hospital of Shandong University in China from August 2001 to September 2010 were evaluated.
  
  
  RESULTS
  Of the 11 men and 224 women on whom the procedure had been attempted, all but seven successfully underwent ET, 145 (63.6%) via a modified anterior chest approach, and 83 (36.4%) via a breast approach. Age ranged from 17 to 52 years, with a mean of 34.5 years. Surgery was limited, in the case of masses, to lesions smaller than 6 cm ultrasonographically. All patients were followed for at least 3 months. The 24 and 48 hours Visual Analog Scale postoperative measurements were low. Complications included four cases of cutaneous emphysema, five seromas, four episodes of anterior chest discomfort, three transient laryngeal nerve palsies, and four episodes of hypocalcemia. The seven procedures that had been converted to an open procedure comprised two patients discovered at frozen section to have poorly differentiated thyroid carcinoma, two with tumors larger than 5 cm, and three with thyroiditis.
  
  
  CONCLUSIONS
  ET is readily learned, provided the surgeon is competent at both laparoscopic technique and open thyroidectomy. Procedural advantages of an endoscopic approach include superior cosmesis and decreased invasiveness.
authors: Department of General Surgery, Qilu Hospital of Shandong University, Jinan, China.
authors: Bo
authors: B
authors: Chen
authors: Yanlei
authors: Y
authors: Wang
authors: Shijin
authors: S
authors: Xuan
authors: Guangyong
authors: G
authors: Zhang
authors: Sanyuan
authors: S
authors: Hu
authors: Mitchell S
authors: MS
authors: Wachtel
authors: Eldo E
authors: EE
authors: Frezza
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D002291:Carcinoma, Papillary / Q000601:surgery; D002681:China; D004724:Endoscopy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006044:Goiter, Nodular / Q000601:surgery; D006111:Graves Disease / Q000601:surgery; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000295:instrumentation / Q000379:methods*; D055815:Young Adult