title: Endoscopic thyroid surgery via a breast approach: a single institution's experiences.
abstract: BACKGROUND
  Thyroid carcinoma in young women is rapidly increasing, and cosmesis plays an important role in thyroid operations. Various endoscopic thyroid surgery approaches have been performed, and their application has recently been extended. We performed endoscopic thyroid surgeries via a breast approach since 1999. Herein, we evaluate the safety of this approach and identify the outcomes for differentiated thyroid carcinoma.
  
  
  METHODS
  A total of 452 consecutive patients with thyroid and parathyroid disease underwent endoscopic thyroidectomy via a breast approach at Uijeongbu St. Mary's Hospital between November 1999 and December 2012. The inclusion criteria for endoscopic thyroidectomy included a benign tumour less than 4 cm in diameter, malignant thyroid nodules less than 2 cm, and no evidence of lymph node metastasis or local invasion. We analysed the clinicopathologic data and surgical factors of this approach.
  
  
  RESULTS
  The mean age of the patients was 38.4 ± 10.6 years (range 11-73 years). The mean tumour size was 2.12 ± 1.17 cm (range 0.1-4 cm). The final tumour pathologies included papillary carcinoma (n = 120), follicular carcinoma (n = 8), nodular hyperplasia (n = 266), follicular adenoma (n = 43), and Hüthle cell adenoma (n = 4). The mean postoperative hospital stay was 3.8 ± 1.3 days (range 1-17 days). Temporary and permanent hypoparathyroidism requiring calcium and vitamin D supplementation developed in 32 (7.1%) and 4 (0.9%) patients, respectively. Transient vocal cord paresis occurred in 20 (4.4%) patients.
  
  
  CONCLUSIONS
  For patients with benign and low-risk malignant thyroid disease, endoscopic thyroidectomy via a breast approach is a safe, feasible, and minimally invasive surgical method with minimal complications.
authors.forename: Yong-Seok
authors.initials: YS
authors.lastname: Kim
authors.forename: Kyu-Hwa
authors.initials: KH
authors.lastname: Joo
authors.forename: Sun-Cheol
authors.initials: SC
authors.lastname: Park
authors.forename: Kee-Hwan
authors.initials: KH
authors.lastname: Kim
authors.forename: Chang-Hyuck
authors.initials: CH
authors.lastname: Ahn
authors.affiliation: Department of Surgery, Uijeongbu St, Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea. drbreast@catholic.ac.kr.
authors.forename: Jeong-Soo
authors.initials: JS
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000473:pathology / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
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