Gasless transaxillary endoscopic thyroidectomy: a decade on.
OBJECTIVE
In 2001, the authors developed a novel method of gasless transaxillary endoscopic thyroidectomy (ET) and have now performed >1000 operations. This review was performed to document surgical outcomes after 10 years of experience with this technique and to determine what the role of ET has in the current era.


METHODS
All patients who underwent elective ET using the gasless transaxillary approach from November 2001 to December 2010 were evaluated. Patient demographics, surgical data, histologic analysis results, and complications were recorded and analyzed.


RESULTS
A total of 1085 patients underwent ET during the study period. Mean patient age was 36.9±9.7 years; the gender ratio was 1:49 (male:female). There were 228 benign thyroid tumor cases and 857 thyroid malignancies. Trend analysis showed a progressive increase in case numbers per month until the end of 2007, followed by a steady decline. There were 175 total thyroidectomy cases and 910 cases of less-than-total thyroidectomy. Mean overall operating time was 132.92±48.6 minutes, and the overall complication rate was 13.5%. The most common complications were: transient hypocalcemia (6.3%), transient hoarseness (3.9%), hematoma (0.4%), permanent hypocalcemia (0.1%), and permanent recurrent laryngeal nerve injury (0.2%).


CONCLUSIONS
Gasless ET is comparable to open thyroidectomy in terms of early surgical outcomes and complications, and it bridges the gap between conventional open surgery and robotic transaxillary thyroidectomy.
Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea.
Nor Azham
NA
Hakim Darail
So Hee
SH
Lee
Sang-Wook
SW
Kang
Jong Ju
JJ
Jeong
Kee-Hyun
KH
Nam
Woong Youn
WY
Chung
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003131:Combined Modality Therapy; D004724:Endoscopy / Q000379:methods* / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology; D011300:Preoperative Care / Q000379:methods; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D013964:Thyroid Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods* / Q000706:statistics & numerical data / Q000639:trends; D016896:Treatment Outcome; D055815:Young Adult
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals