title: New endoscopic thyroidectomy with the transareola single-site approach: a comparison with the bilateral areolar approach.
abstract: OBJECTIVE
  We developed the transareola single-site approach (TASSA) for less invasive endoscopic thyroidectomy to avoid scars on exposed areas. Here, we report our experience with the TASSA technique in treatment of benign thyroid tumors and evaluate its feasibility through comparison with the bilateral areolar approach (BAA).
  
  
  METHODS
  From September 2009 to December 2011, 129 patients with benign thyroid tumors were enrolled in the study. Of these patients, 51 patients underwent endoscopic thyroidectomy by TASSA and 78 patients by BAA. The TASSA technique was performed using one 10 mm trocar and one 5 mm trocar through circumareolar incisions using conventional endoscopic instruments. The BAA procedure was performed using one 10 mm trocar and two 5 mm trocars through bilateral circumareolar incisions.
  
  
  RESULTS
  Comparing TASSA with BAA, there were significant differences in the mean operative time (141.96 ± 19.85 vs. 98.14 ± 14.15 min) for lobectomy (P<0.05) and in the subcutaneous dissection area (101.00 ± 6.33 vs. 132.51 ± 5.25 cm, P<0.05). However, there were no significant differences in the duration of hospitalization, amount of drainage, occurrence of postoperative complications, and postoperative pain. All the patients were satisfied with the cosmetic result in the 2 groups.
  
  
  CONCLUSIONS
  Endoscopic thyroidectomy using the TASSA procedure is feasible and safe, and affords the advantages of minimal invasiveness and excellent cosmesis results compared with other approaches including BAA. The 2 procedures are technically more challenging procedures, which may become alternative procedures for treatment of patients with benign thyroid tumors, especially those with strong desire for cervical cosmesis.
authors.affiliation: Department of General Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai JiaoTong University, Shanghai, China.
authors.forename: Bo-Min
authors.initials: BM
authors.lastname: Guo
authors.forename: Bo
authors.initials: B
authors.lastname: Wu
authors.forename: Jie
authors.initials: J
authors.lastname: Kang
authors.forename: Xian-Zhao
authors.initials: XZ
authors.lastname: Deng
authors.forename: Huan-Long
authors.initials: HL
authors.lastname: Qin
authors.forename: You-Ben
authors.initials: YB
authors.lastname: Fan
mesh_terms: D000328:Adult; D004724:Endoscopy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D061646:Operative Time; D017060:Patient Satisfaction; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome