title: Trans-areola single-site endoscopic thyroidectomy: pilot study of 35 cases.
abstract: BACKGROUND
  Endoscopic thyroidectomy via thoracic/breast approach is an acceptable and successful technique in Asia. This technique has the advantage of better cosmesis compared with open or even video-assisted thyroidectomy. Unfortunately, because of the need for three separate ports, conventional endoscopic thyroidectomy usually involves significantly more tissue dissection, and thus more injury to patients, limiting the popularity of this technique. We herein present 35 cases of trans-areola single-site endoscopic thyroidectomy (TASSET), which was first performed in 2009.
  
  
  METHODS
  Thirty-five patients who underwent TASSET for thyroid nodules from September 2009 to March 2011 were evaluated. The surgical outcomes of the surgery were retrospectively analyzed, including conversion, operative time, estimated blood loss, complications, length of stay, and patient satisfaction.
  
  
  RESULTS
  Thirty-one of the 35 patients (88.5%) underwent successful TASSET, with subtotal lobectomy being the most common procedure. Median operative time for the surgery was 153.65 min (range 100-190 min). Estimated blood loss ranged from 20 to 40 mL. Length of postoperative stay ranged from 2 to 4 days (average 2.5 days). Visual analog scale scores were 0 to 4 without administration of analgesics. The complication rate was low (8.6%) and included one case of transient recurrent laryngeal nerve (RLN) palsy, one case of subcutaneous seroma, and one case of tracheal injury. All patients were satisfied with the cosmetic outcome after mean follow-up of 8 months.
  
  
  CONCLUSIONS
  TASSET is feasible and safe, with great cosmetic benefits and less injury than other procedures. It may become an alternative procedure for treatment of patients with benign thyroid tumors, especially those with strong desire for cervical cosmesis.
authors.affiliation: Department of General Surgery, Center of Thyroid, Affiliated Sixth People's Hospital, Medical School, Shanghai JiaoTong University, 600 Yishan Road, Shanghai, 200233, China. fanyouben2006@163.com
authors.forename: Fan
authors.initials: F
authors.lastname: Youben
authors.forename: Wu
authors.initials: W
authors.lastname: Bo
authors.forename: Zhong
authors.initials: Z
authors.lastname: Chunlin
authors.forename: Kang
authors.initials: K
authors.lastname: Jie
authors.forename: Guo
authors.initials: G
authors.lastname: Bomin
authors.forename: Yang
authors.initials: Y
authors.lastname: Fan
authors.forename: Deng
authors.initials: D
authors.lastname: Xianzhao
authors.forename: Zheng
authors.initials: Z
authors.lastname: Qi
mesh_terms: D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D001940:Breast / Q000601:surgery; D004724:Endoscopy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D010865:Pilot Projects; D012189:Retrospective Studies; D016606:Thyroid Nodule / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D055815:Young Adult