title: Prospective comparative study of endoscopic via unilateral axillobreast approach versus open conventional total thyroidectomy in patients with papillary thyroid carcinoma.
abstract: Total thyroidectomy can be accomplished in one of two ways. The first is an open conventional approach, and the other is an endoscopic unilateral axillobreast approach (UABA). However, the two have not been thoroughly compared. In the study described herein, we compare the technical feasibility, safety, and surgical completeness of open versus endoscopic total thyroidectomy procedures.
  
  
  
  A total of 152 patients who underwent open (n = 102) or endoscopic (n = 50) total thyroidectomy via UABA for papillary microcarcinoma from January to December 2011 were enrolled in this study. Data were collected prospectively after obtaining informed consent. We analyzed the clinical characteristics, pathologic results, postoperative thyroglobulin (Tg) levels, and results of radioactive iodine treatment between the two groups.
  
  
  
  We conclude that endoscopic thyroidectomy resulted in a younger age, lower body mass index, longer operation time and drain maintenance, and larger drain amount. There were no significant differences with respect to gender, hospital stay, tumor size, time for central compartment neck dissection, number of harvested ipsilateral lymph nodes, or bleeding amount between groups. The proportion of extrathyroidal extension, multifocality, and bilaterality did not differ, and the surgical complication rate was similar. In addition, the postoperative stimulated and non-stimulated Tg levels did not differ significantly, nor did the thyroid bed/brain iodine uptake ratio.
  
  
  
  Based on our results, endoscopic total thyroidectomy via UABA is technically feasible and has comparable surgical completeness to open total thyroidectomy for papillary microcarcinoma within 1 cm.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, SoonChunHyang University College of Medicine, Bucheon, Korea.
authors.forename: Ki Nam
authors.initials: KN
authors.lastname: Park
authors.affiliation: Department of Endocrinology, Division of Internal Medicine, SoonChunHyang University College of Medicine, Bucheon, Korea.
authors.forename: Chan-Hee
authors.initials: CH
authors.lastname: Jung
authors.affiliation: Department of Endocrinology, Division of Internal Medicine, SoonChunHyang University College of Medicine, Bucheon, Korea.
authors.forename: Ji Oh
authors.initials: JO
authors.lastname: Mok
authors.affiliation: Department of Pathology, SoonChunHyang University College of Medicine, Bucheon, Korea.
authors.forename: Jung Ja
authors.initials: JJ
authors.lastname: Kwak
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, SoonChunHyang University College of Medicine, Bucheon, Korea. lsw0922@naver.com.
authors.forename: Seung Won
authors.initials: SW
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla / Q000601:surgery; D002277:Carcinoma / Q000601:surgery*; D002291:Carcinoma, Papillary / Q000601:surgery; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D061646:Operative Time; D011184:Postoperative Period; D011446:Prospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*
keywords: Endoscopic surgical procedure; Papillary thyroid microcarcinoma; Thyroidectomy