title: Total endoscopic thyroidectomy via bilateral breast and ipsilateral axillary approach: a clinical feasibility study.
abstract: The most commonly used minimally invasive thyroid surgery via noncervical approach is the bilateral breast approach, but there was usually a scar in the chest wall, which induced uncomfortable and bad cosmetic result. For this reason, endoscopic thyroidectomy via bilateral breast and ipsilateral axillary approach had been developed. The aims of this study are to analyze our surgical outcomes and to evaluate the effectiveness and safety. Between May 2011 and August 2012, 64 patients with thyroid diseases underwent endoscopic thyroidectomy via bilateral breast and ipsilateral axillary approach. The patients' clinical data, operative time, blood loss, drainage amounts, complications, hospital stay, area of skin flap, and postoperative visual analog pain score (VAS) were analyzed retrospectively. We describe here the details of our operative technique. All the 64 patients successfully underwent endoscopic thyroidectomy. None had to be converted, and no postoperative complications were observed. Mean operation time was 104.0 ± 25.3 minutes. Mean blood loss was 10.5 ± 3.7 mL. Mean average area of skin flap was 78.6 ± 8.6 cm2. Mean postoperative drainage amounts on day 1 were 84.5 ± 62.6 mL. Mean hospital stay was 2 to 3 days. The postoperative VAS scores on day 1 were 0 to 2. Follow-up visits range from 2 to 12 months, suggesting that no one had a relapse. Furthermore, the patients were uniformly pleased with the cosmetic results of the operation. Bilateral breast and ipsilateral axillary approach is a safe and easily popularized method that gives good surgical completeness, quick recovery, less pain, less postoperative complications, and an excellent cosmetic result. Therefore, this method is a good choice for patients with surgical thyroid diseases.
authors.affiliation: From the *Department of General Surgery, The First Affiliated Hospital of Guangxi Medical University (West), Nanning; and †Guangxi Medical University, Nanning, Guangxi, China.
authors.forename: Xiaojian
authors.initials: X
authors.lastname: Jin
authors.forename: Bangyu
authors.initials: B
authors.lastname: Lu
authors.forename: Xiaoyong
authors.initials: X
authors.lastname: Cai
authors.forename: Yubin
authors.initials: Y
authors.lastname: Huang
authors.forename: Lulu
authors.initials: L
authors.lastname: Huang
authors.forename: Wenqi
authors.initials: W
authors.lastname: Lu
authors.forename: Yihe
authors.initials: Y
authors.lastname: Yan
authors.forename: Jianjun
authors.initials: J
authors.lastname: Li
mesh_terms: D000236:Adenoma / Q000601:surgery; D000328:Adult; D000368:Aged; D001365:Axilla / Q000601:surgery; D016063:Blood Loss, Surgical; D001940:Breast / Q000601:surgery; D004322:Drainage; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006044:Goiter, Nodular / Q000601:surgery; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D061646:Operative Time; D010149:Postoperative Pain / Q000145:classification; D011183:Postoperative Complications; D012189:Retrospective Studies; D012449:Safety; D016606:Thyroid Nodule / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult