title: Clinical experience with modified Miccoli's endoscopic thyroidectomy for treatment of thyroid carcinoma in 86 cases.
abstract: BACKGROUND
  The main purpose of this study was to assess the feasibility and relevant applying techniques of total thyroidectomy for thyroid carcinoma with a modified Miccoli's approach.
  
  
  METHODS
  Eighty-six patients with thyroid carcinoma consecutively received radical operation from October 2007 to June 2012. A cavity above the gland was constructed by a modified suspension method using the suspension retractor with suction catheter after the pathway making. Eighty-six cases underwent the modified Miccoli's endoscopic thyroidectomy using the ultrasonic scalpel and the space maintain-regulating device. Level VI lymph node dissection was performed using the method of inspection pit.
  
  
  RESULTS
  All the procedures were completed successfully. The average detection rate of level VI lymph nodes, the average time of thyroidectomy and lymph nodes dissection were 7.27 ± 3.99 pieces per case, 51.32 ± 13.35 min, and 38.43 ± 15.24 min, respectively. With regard to postoperative complications, there were three cases of delayed transient hoarseness, two patients with transient numbness of hands and feet, one subject with chylous fistula, and no hemorrhage.
  
  
  CONCLUSIONS
  Total thyroidectomy for thyroid carcinoma can be safely performed with the modified Miccoli's approach by using ultrasonic scalpel and the space maintain-regulating device. Application of these adaptive reforms can obviously reduce the difficulties in manipulation and have the advantages of minimal incisions, good cosmetic results, less bleeding, shorter hospital stay, and fewer complications.
authors.affiliation: Department of Breast Surgery, the First People Hospital of Zhangjiagang, No 68 Jiyang West Road, Zhangjiagang, Jiangsu 215600, China. zjgshenxiang@126.com.
authors.forename: Xiang
authors.initials: X
authors.lastname: Shen
authors.forename: Zhi-Ming
authors.initials: ZM
authors.lastname: Miao
authors.forename: Wei
authors.initials: W
authors.lastname: Lu
authors.forename: Da-Li
authors.initials: DL
authors.lastname: Gu
authors.forename: Dan
authors.initials: D
authors.lastname: Yang
authors.forename: Hao
authors.initials: H
authors.lastname: Shen
authors.forename: Feng
authors.initials: F
authors.lastname: Geng
mesh_terms: D000328:Adult; D000368:Aged; D004724:Endoscopy; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy; D055815:Young Adult