Endoscopy-assisted thyroid surgery via a subclavian approach.
OBJECTIVE
To evaluate the effectiveness of an endoscopy-assisted surgical technique, designed to leave a scar-free neck, for removing large benign thyroid tumors.


METHODS
The subjects were 63 patients who underwent endoscopy-assisted surgery via a subclavian approach (endoscopic group) and 79 patients who underwent similar surgery via the conventional approach (conventional group). With the endoscopy-assisted approach, a 4-6 cm incision was made over the larger side of the tumor, at the lower edge of the clavicle, 3-5 cm beside the midline.


RESULTS
There was no significant difference in the distribution of patients within each group and pathological examination proved benign for all patients. The cosmetic results of the endoscopic group were significantly better than those of the conventional group (Z = 9.900, P = 0.000). None of the patients in either group suffered permanent recurrent laryngeal nerve paralysis. The only minor complications in the endoscopic group were transient hypocalcemia, which resolved within 1 week (n = 2); skin tension which cleared up within 3 months (n = 2); and temporary recurrent laryngeal nerve paralysis, which resolved within 1 month (n = 1). No significant distinction was found between the endoscopic group and the conventional group (χ (2) = 1.129, P = 0.466).


CONCLUSIONS
Endoscopic surgery via a subclavian approach is appropriate and effective for treating patients with a benign thyroid tumor larger than 4 cm.
Department of Otolaryngology-Head and Neck, Affiliated Second Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou 510120, China.
Qian
Q
Cai
Xiaoming
X
Huang
Ping
P
Han
Wei
W
Sun
Faya
F
Liang
Xiaoyu
X
Jiang
D000328:Adult; D002921:Cicatrix / Q000517:prevention & control; D002968:Clavicle; D004724:Endoscopy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck; D011446:Prospective Studies; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*