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Liu Y, Wang J, Chen S, Cao G. Endoscopic total thyroidectomy using a unilateral transaxillary approach: A case report. J Int Med Res 2023; 51:3000605231158962. [PMID: 36916073 PMCID: PMC10021092 DOI: 10.1177/03000605231158962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Endoscopic transaxillary thyroidectomy is a common method for remote-access thyroidectomy. The approach typically uses a gasless method, and a long incision to insert a special retractor. In addition, it is considered only suitable for unilateral lobectomy because of problems accessing contralateral parts of the thyroid gland. We describe here, a case of a young woman who had a total thyroidectomy performed using an endoscopic approach. We reduced the non-inflated 4-6 cm incision that is usually required, into three holes, and performed unilateral transaxillary thyroidectomy; this was verified by radioactive iodine uptake and thyroglobulin levels during follow-up. The approach was clinically successful and resulted in minimal scarring. More studies are required to optimize this promising technique.
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Affiliation(s)
- Yang Liu
- Yang Liu, Xi'an Jiaotong University Second
Affiliated Hospital, No. 157, Xiwulu, Xi'an, 710004, China.
| | | | | | - Gang Cao
- Gang Cao, Xi'an Jiaotong University Second
Affiliated Hospital, Xi'an, Shaanxi 710004, China.
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Saavedra-Pérez D, Manyalich M, Domínguez P, Farguell J, Rull R, López-Boado MÁ, Vilaça J, Vidal Ó. Unilateral axilo-breast approach (UABA) with gas insufflation versus open conventional hemithyroidectomy: A prospective comparative study. Cir Esp 2023; 101:107-115. [PMID: 36100055 DOI: 10.1016/j.cireng.2022.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/17/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND The objective of this study was to compare with the conventional open approach, the surgical and aesthetic results of endoscopic thyroidectomy via unilateral axillo-breast approach (UABA) with gas insufflation in patients with a unilateral thyroid nodule. METHODS Between August 2017 and August 2020, a prospective comparative cohort study was carried out in patients proposed for hemithyroidectomy. The patients were assigned to one type of approach (Open or Endoscopic) in a successive manner. Surgical results and aesthetic satisfaction at hospital discharge and during the 12-month follow-up were evaluated and compared between both groups. RESULTS A total of 200 patients were included in the study: 100 for the Open approach and 100 for the Endoscopic. The baseline patient characteristics were similar between both groups. Total operative time was longer in the Endoscopic approach, due to the time required for subcutaneous dissection (the hemithyroidectomy time was similar in both groups). There was no significant difference in the frequency of major complications. The length of hospital stay was longer (for 1 day) in the Endoscopic group. The aesthetic satisfaction of the patients was significantly higher in the Endoscopic than in the Open group (p < 0.001), at hospital discharge and at 12-month follow-up. CONCLUSION UABA with gas insufflation for hemithyroidectomy represents a safe and effective therapeutic option for the treatment of unilateral benign thyroid pathologies.
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Affiliation(s)
- David Saavedra-Pérez
- Unidad de Endocrinología Médico-Quirúrgica, Cirugía Endocrina, Servicio de Cirugía General y del Aparato Digestivo, Instituto Clínic de Enfermedades Digestivas y Metabólicas (ICMDiM), Hospital Clínic de Barcelona, Universidad de Barcelona, IDIBAPS, Barcelona, Spain.
| | - Marti Manyalich
- Unidad de Endocrinología Médico-Quirúrgica, Cirugía Endocrina, Servicio de Cirugía General y del Aparato Digestivo, Instituto Clínic de Enfermedades Digestivas y Metabólicas (ICMDiM), Hospital Clínic de Barcelona, Universidad de Barcelona, IDIBAPS, Barcelona, Spain
| | - Paula Domínguez
- Unidad de Endocrinología Médico-Quirúrgica, Cirugía Endocrina, Servicio de Cirugía General y del Aparato Digestivo, Instituto Clínic de Enfermedades Digestivas y Metabólicas (ICMDiM), Hospital Clínic de Barcelona, Universidad de Barcelona, IDIBAPS, Barcelona, Spain
| | - Jordi Farguell
- Unidad de Endocrinología Médico-Quirúrgica, Cirugía Endocrina, Servicio de Cirugía General y del Aparato Digestivo, Instituto Clínic de Enfermedades Digestivas y Metabólicas (ICMDiM), Hospital Clínic de Barcelona, Universidad de Barcelona, IDIBAPS, Barcelona, Spain
| | - Ramón Rull
- Unidad de Endocrinología Médico-Quirúrgica, Cirugía Endocrina, Servicio de Cirugía General y del Aparato Digestivo, Instituto Clínic de Enfermedades Digestivas y Metabólicas (ICMDiM), Hospital Clínic de Barcelona, Universidad de Barcelona, IDIBAPS, Barcelona, Spain
| | - Miguel Ángel López-Boado
- Unidad de Endocrinología Médico-Quirúrgica, Cirugía Endocrina, Servicio de Cirugía General y del Aparato Digestivo, Instituto Clínic de Enfermedades Digestivas y Metabólicas (ICMDiM), Hospital Clínic de Barcelona, Universidad de Barcelona, IDIBAPS, Barcelona, Spain
| | - Jaime Vilaça
- Departamento de Cirugía General y del Aparato Digestivo, Hospital da Luz Arrábida, Escola de Medicina, Universidade do Minho, Braga, Porto, Portugal
| | - Óscar Vidal
- Unidad de Endocrinología Médico-Quirúrgica, Cirugía Endocrina, Servicio de Cirugía General y del Aparato Digestivo, Instituto Clínic de Enfermedades Digestivas y Metabólicas (ICMDiM), Hospital Clínic de Barcelona, Universidad de Barcelona, IDIBAPS, Barcelona, Spain
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Saavedra-Perez D, Manyalich M, Dominguez P, Vilaça J, Jordan J, Lopez-Boado MA, Rull R, Vidal O. Thyroidectomy via unilateral axillo-breast approach (UABA) with gas insufflation: prospective multicentre European study. BJS Open 2022; 6:6633734. [PMID: 35799351 PMCID: PMC9263156 DOI: 10.1093/bjsopen/zrac087] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 05/05/2022] [Accepted: 05/20/2022] [Indexed: 11/23/2022] Open
Abstract
Background Extracervical approaches for thyroidectomy are seldom explored in the western population. The objective of this study was to evaluate the outcomes of hemithyroidectomy via endoscopic unilateral axillo-breast approach (UABA) with gas insufflation. Method Consecutive patients undergoing UABA hemithyroidectomy for symptomatic benign or cytologically indeterminate nodules (Bethesda III lesions) of less than 5 cm from July 2015 to December 2020 at three European institutions were included. Patients were excluded if presenting with a BMI more than 25 kg/m2, had previous neck surgery and/or radiation, had bilateral thyroid lesions, retrosternal goitre, Hashimoto thyroiditis or Graves’ disease. Follow-up was carried out at 2 weeks, 3 months and 1 year. Outcomes of interest were surgical (including operating time, mean duration of hospital stay and complications) and self-assessed cosmetic outcomes. Results Out of 984 patients treated with hemithyroidectomy during the study interval, 253 were selected, including 214 women and 39 men. Patients’ mean age was of 46.6 years with a mean BMI of 22.57. Mean operating time was 72.9 minutes. A transient recurrent laryngeal nerve injury was reported in 3.6 per cent of the patients, but none was persistent. Transient pectoral/cervical hypoesthesia was noted in 24.1 per cent of patients, with no permanent hypoesthesia. Skin burns and subcutaneous hematoma developed in 2.4 per cent and 2 per cent of patients but resolved within the third month after surgery. There was no tracheal/oesophageal perforation, conversion to open surgery or reoperation. The final pathology revealed 241 benign nodules, nine underlying papillary thyroid carcinomas, and three cases of follicular carcinoma. Hospital discharge was achieved on the first in 68.8 per cent of the patients and on the second postoperative day in 31.2 per cent of the cases. All patients were satisfied with the cosmetic aspect. Conclusion In selected patients, UABA with gas insufflation for hemithyroidectomy could be performed for the treatment of unilateral thyroid pathologies.
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Affiliation(s)
- David Saavedra-Perez
- Unit of Medical and Surgical Endocrinology, Endocrine Surgery, Department of General and Digestive Surgery, Hospital Clinic of Barcelona, University of Barcelona , Barcelona , Spain
| | - Marti Manyalich
- Unit of Medical and Surgical Endocrinology, Endocrine Surgery, Department of General and Digestive Surgery, Hospital Clinic of Barcelona, University of Barcelona , Barcelona , Spain
| | - Paula Dominguez
- Unit of Medical and Surgical Endocrinology, Endocrine Surgery, Department of General and Digestive Surgery, Hospital Clinic of Barcelona, University of Barcelona , Barcelona , Spain
| | - Jaime Vilaça
- Endocrine Surgery, Department of General and Digestive Surgery, Hospital da Luz Arrábida, Universidade do Minho , Porto , Portugal
| | - Julio Jordan
- Endocrine Surgery, Department of General and Digestive Surgery, University Hospital Nuestra Señora de la Candelaria, La Laguna University , Tenerife , Spain
| | - Miguel A Lopez-Boado
- Unit of Medical and Surgical Endocrinology, Endocrine Surgery, Department of General and Digestive Surgery, Hospital Clinic of Barcelona, University of Barcelona , Barcelona , Spain
| | - Ramon Rull
- Unit of Medical and Surgical Endocrinology, Endocrine Surgery, Department of General and Digestive Surgery, Hospital Clinic of Barcelona, University of Barcelona , Barcelona , Spain
| | - Oscar Vidal
- Unit of Medical and Surgical Endocrinology, Endocrine Surgery, Department of General and Digestive Surgery, Hospital Clinic of Barcelona, University of Barcelona , Barcelona , Spain
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Lee MC, Ahn J, Choi IJ, Lee BC, Ryu J. Comparative study of transaxillary, bilateral axillo-breast, unilateral axillo-breast with gas insufflation, retroauricular, and transoral endoscopic thyroidectomy approaches in a single institute:retrospective analysis and lessons learnt from experiences. Clin Exp Otorhinolaryngol 2022; 15:283-291. [PMID: 35538719 PMCID: PMC9441504 DOI: 10.21053/ceo.2021.02285] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 04/11/2022] [Indexed: 11/22/2022] Open
Abstract
Objectives. This study aimed to present our experiences with various approaches for endoscopic thyroidectomy (ET) and to offer lessons for choosing an approach.Method. The medical records of 701 patients who underwent ET via different approaches such as transaxillary (TA), bilateral axillo-breast (BABA), unilateral axillo-breast with carbon dioxide insufflation (UABA), retroauricular (RA), or transoral vestibular (TO) between May 2008 and March 2020 were retrospectively reviewed.Results. The mean operative time of UABA was the shortest among five approaches (TA 194.65
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Saavedra-Pérez D, Manyalich M, Domínguez P, Farguell J, Rull R, López-Boado MÁ, Vilaça J, Vidal Ó. Hemitiroidectomía vía abordaje axilo-mamario unilateral (UABA) con insuflación de gas vs. convencional abierta: estudio prospectivo comparativo. Cir Esp 2022. [DOI: 10.1016/j.ciresp.2022.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Nguyen HX, Nguyen HX, Le AD, Van Le Q. Comparison of Transoral Endoscopic Thyroidectomy Vestibular Approach and Conventional Open Thyroidectomy in Benign Thyroid Tumors. Indian J Surg Oncol 2022; 13:178-183. [PMID: 35462668 PMCID: PMC8986896 DOI: 10.1007/s13193-022-01494-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 01/06/2022] [Indexed: 01/06/2023] Open
Abstract
Conventional open thyroidectomy remains the standard treatment of surgery for benign thyroid tumors but leaves a permanent scar in the neck. We conducted this study to compare the surgical outcomes of transoral endoscopic thyroidectomy vestibular approach (TOETVA) versus conventional open thyroidectomy (COT), and thence analyze the safety and viability of this approach. Seventy-eight patients who had undergone either COT or TOETVA from 2020 to 2021 in our institution to treat benign thyroid tumors were prospectively studied. Outcomes between the two groups were analyzed, including time of operation, blood loss, hospital stay, postoperative complications, and level of satisfaction. A total of 78 patients, in which TOETVA was applied to 47 patients and COT thyroid surgery was applied to 31 patients, participated in this study. COT has a shorter operative time (59.8 ± 10.8 min versus 102.3 ± 34.9 min, p < .001). TOETVA is less painful postoperatively (visual analog scale score on day 4 of 1.1 ± 1.2 versus 1.8 ± 0.7, p < .001). There were no significant differences between TOETVA and COT groups regarding incidences of transient recurrent laryngeal nerve (RLN) injury (10.6% and 6.5%, respectively, p = .697) and both transient and permanent hypoparathyroidism (8.5% versus 3.5%, p = .644 with transient and 0% versus 6.7%, p = .166 with permanent). Other complications were comparable between two arms such as bleeding, seroma, and infection. At 3 months after surgery, the TOETVA group had the significantly higher proportion of the very satisfied level than the COT group (80.9% versus 35.4%, p < .001). TOETVA in patients with favorable features is a safe, viable alternative to open thyroidectomy regarding postoperative outcomes and provide higher satisfaction after surgery in the long term.
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Affiliation(s)
- Hau Xuan Nguyen
- Department of Oncology, Hanoi Medical University, No. 1 Ton That Tung Street, Dong Da District, Hanoi, Vietnam ,Department of Oncology and Palliative Care, Hanoi Medical University Hospital, No. 1 Ton That Tung Street, Dong Da District, Hanoi, 100000 Vietnam
| | - Hien Xuan Nguyen
- Department of Oncology and Palliative Care, Hanoi Medical University Hospital, No. 1 Ton That Tung Street, Dong Da District, Hanoi, 100000 Vietnam
| | - Anh Duc Le
- Department of Oncology, Hanoi Medical University, No. 1 Ton That Tung Street, Dong Da District, Hanoi, Vietnam
| | - Quang Van Le
- Department of Oncology, Hanoi Medical University, No. 1 Ton That Tung Street, Dong Da District, Hanoi, Vietnam ,Department of Oncology and Palliative Care, Hanoi Medical University Hospital, No. 1 Ton That Tung Street, Dong Da District, Hanoi, 100000 Vietnam
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Ryu CH, Seok J, Jung YS, Ryu J. Novel robot-assisted thyroidectomy by a transaxillary gas-insufflation approach (TAGA): a preliminary report. Gland Surg 2020; 9:1267-1277. [PMID: 33224801 DOI: 10.21037/gs-20-450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background Robot-assisted transaxillary approaches to thyroidectomy have been well described. They have an advantage over the breast approach in that a circumareolar incision is avoided. However, they require a single long axillary incision to accommodate all 3 robotic arms and provide adequate visualization of the area around the thyroid. The purpose of this study was to test the feasibility of the robot-assisted transaxillary gas-insufflation approach (TAGA) and to attempt reducing the size of the scar. Methods We evaluated 47 patients who underwent robot-assisted thyroid lobectomy via TAGA from July 2015 to Aug 2017. The following variables were studied: patients' demographics, operative time according to each operation step, volume of drainage, duration of hospitalization, and perioperative complications. Results The mean age of all patients was 42.4±9.1 years. The mean total volume of drainage was 195.4±70.9 mL, and the duration of postoperative stay was 3.0±1.1 days. Two cases (4.3%) of transient vocal cord palsy and 2 cases (4.3%) of seroma were identified postoperatively. There was no post-operative cosmetic problem at the skin incisions made in the axilla. Conclusions Robot-assisted thyroid lobectomy via TAGA is technically feasible while achieving good cosmetic results. TAGA can be an alternative robot-assisted method for thyroidectomy.
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Affiliation(s)
- Chang Hwan Ryu
- Department of Otorhinolaryngology-Head and Neck Surgery, National Cancer Center, Goyang, Republic of Korea
| | - Jungirl Seok
- Department of Otorhinolaryngology-Head and Neck Surgery, National Cancer Center, Goyang, Republic of Korea
| | - Yuh-Seog Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, National Cancer Center, Goyang, Republic of Korea
| | - Junsun Ryu
- Department of Otorhinolaryngology-Head and Neck Surgery, National Cancer Center, Goyang, Republic of Korea
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Moreno Llorente P, A Gonzales Laguado E, Alberich Prats M, Francos Martínez JM, García Barrasa A. Surgical approaches to thyroid. Cir Esp 2020; 99:267-275. [PMID: 33069356 DOI: 10.1016/j.ciresp.2020.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/08/2020] [Accepted: 08/11/2020] [Indexed: 01/03/2023]
Abstract
Thyroidectomy is the most frequent procedure in endocrine surgery. The conventional approach through a collar incision, as described by Kocher in XIXth century, has become the "gold standard". It is continuously evolving in spite of, many years ago, it showed to be safe and efficient with quality standards difficult to beat. Endoscopic and robotic surgery have developed "new approaches" to thyroid in order to improve the cosmetic results, looking even for invisible scars. We have done a thoughtful review of most of them trying to understand their benefits and drawbacks. Currently none of these "new approaches" have been shown to be better than conventional open thyroidectomy beyond offering a better cosmetic result. Besides, only a small percentage of patients can benefit of them. However, most of these approaches will remain if they treat the diseased thyroid and also improve the quality of life of our patients.
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Affiliation(s)
- Pablo Moreno Llorente
- Unidad de Cirugía Endocrina, Hospital Universitari de Bellvitge, Universidad de Barcelona (UB), L'Hospitalet de Llobregat, Barcelona, España.
| | - Erick A Gonzales Laguado
- Unidad de Cirugía Endocrina, Hospital Universitari de Bellvitge, Universidad de Barcelona (UB), L'Hospitalet de Llobregat, Barcelona, España
| | - Marta Alberich Prats
- Unidad de Cirugía Endocrina, Hospital Universitari de Bellvitge, Universidad de Barcelona (UB), L'Hospitalet de Llobregat, Barcelona, España
| | - José Manuel Francos Martínez
- Unidad de Cirugía Endocrina, Hospital Universitari de Bellvitge, Universidad de Barcelona (UB), L'Hospitalet de Llobregat, Barcelona, España
| | - Arantxa García Barrasa
- Unidad de Cirugía Endocrina, Hospital Universitari de Bellvitge, Universidad de Barcelona (UB), L'Hospitalet de Llobregat, Barcelona, España
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Endoscopic thyroidectomy via axillary-breast-shoulder approach: Early experience of 42 cases. Surg Oncol 2020; 34:318-323. [PMID: 32781312 DOI: 10.1016/j.suronc.2020.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 05/17/2020] [Accepted: 05/22/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Most patients in Indonesia present with large-sized thyroid nodules, which need surgical removal to exclude malignancy. Many surgeons prefer endoscopic thyroidectomy to avoid a large and visible surgical scar on the neck and to reduce postoperative complications. This study aims to evaluate and analyze surgical feasibility, safety, oncologic outcome, and patient satisfaction of endoscopic thyroidectomy via the axillary-breast-shoulder approach. METHODS Between August 2010 and September 2015, 42 endoscopic thyroidectomies via the axillary-breast-shoulder approach with carbon dioxide insufflation up to 8-10 mmHg were performed and retrospectively reviewed. RESULTS Mean tumor size and operative time were 3.11 ± 0.99 cm and 189 ± 45 min, respectively. Mean blood loss was 68.3 mL. There were temporary complications such as hoarseness (19%), emphysema (2.3%) and hematoma (2.3%). Mean hospital length of stay was 3.98 days. Most subjects (61.9%) were very satisfied with the postoperative scar. The visual analog score of postoperative pain decreased from 4.83 on day-1 to 2.28 on day-7. The tumor recurrence was 9.6%. CONCLUSIONS Endoscopic thyroidectomy via the axillary-breast-shoulder approach is feasible, safe, and minimally invasive with excellent postoperative results.
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Nguyen HX, Nguyen LT, Nguyen HV, Nguyen HX, Trinh HL, Nguyen TX, Le QV. Comparison of Transoral Thyroidectomy Vestibular Approach and Unilateral Axillobreast Approach for Endoscopic Thyroidectomy: A Prospective Cohort Study. J Laparoendosc Adv Surg Tech A 2020; 31:11-17. [PMID: 32486890 DOI: 10.1089/lap.2020.0272] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background: Various approaches for endoscopic thyroidectomy have been developed recently that improve the cosmetic outcome, and some are even scar free. In this study, we compared the safety and surgical outcomes of transoral endoscopic thyroidectomy vestibular approach (TOETVA) and unilateral axillobreast approach (UABA) thyroid surgery performed by a single surgeon. Materials and Methods: We conducted a prospective cohort study among 101 patients undergoing endoscopic thyroidectomy from 2018 to 2019 in our institution. The factors analyzed included patients' clinical characteristics, types and time of operation, blood loss, hospital stay, postoperative complications, and cosmetic satisfaction. Results: Among 101 patients, 51 underwent TOETVA and 50 had UABA surgery. UABA has shorter operative time for lobectomy (91.7 ± 16.5 minutes versus 50.4 ± 6.8 minutes, P < .001), whereas TOETVA is associated with less postoperative pain (visual analogue scale score day 1 of 4.6 ± 1.0 versus 5.8 ± 1.0, P < .001). There were no significant differences between TOETVA and UABA groups regarding rates of transient recurrent laryngeal nerve injury (9.8% versus 2.0%, P = .205) and hypothyroidism (11.5% versus 2.0%, P = .112), in which all patients fully recovered 6 months after surgery and most of them were satisfied with the cosmetic result. Conclusions: Both TOETVA and UABA have been shown to be effective and safe surgical options for endoscopic thyroid surgery, as well as gave excellent cosmetic result. Each approach has its own advantages and disadvantages, and choice of technique should be tailored for each individual, and patient preference should be integrated in the treatment plan.
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Affiliation(s)
- Hau Xuan Nguyen
- Department of Oncology, Hanoi Medical University, Hanoi, Vietnam.,Department of Oncology and Palliative Care, Hanoi Medical University Hospital, Hanoi, Vietnam
| | | | - Hung Van Nguyen
- Department of Oncology and Palliative Care, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Hien Xuan Nguyen
- Department of Oncology, Hanoi Medical University, Hanoi, Vietnam
| | - Huy Le Trinh
- Department of Oncology, Hanoi Medical University, Hanoi, Vietnam.,Department of Oncology and Palliative Care, Hanoi Medical University Hospital, Hanoi, Vietnam
| | | | - Quang Van Le
- Department of Oncology, Hanoi Medical University, Hanoi, Vietnam.,Department of Oncology and Palliative Care, Hanoi Medical University Hospital, Hanoi, Vietnam
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Feasibility and Safety of Endoscopic Thyroidectomy Via a Unilateral Axillobreast Approach for Unilateral Benign Thyroid Tumor in Vietnam. Surg Laparosc Endosc Percutan Tech 2019; 29:447-450. [DOI: 10.1097/sle.0000000000000621] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Vidal O, Saavedra-Perez D, Vilaça J, Pantoja JP, Delgado-Oliver E, Lopez-Boado MA, Fondevila C. Cirugía endocrina cervical mínimamente invasiva. Cir Esp 2019; 97:305-313. [DOI: 10.1016/j.ciresp.2019.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/15/2019] [Accepted: 03/18/2019] [Indexed: 01/29/2023]
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13
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Endoscopic Thyroidectomy Using the Unilateral Axillo-breast Approach Versus the Modified Anterior Chest Wall Approach: A Prospective Comparative Study. Surg Laparosc Endosc Percutan Tech 2018; 28:366-370. [DOI: 10.1097/sle.0000000000000582] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mo K, Zhao M, Wang K, Gu J, Tan Z. Comparison of endoscopic thyroidectomy via a modified axillo-breast approach with the conventional breast approach for treatment of unilateral papillary thyroid microcarcinoma. Medicine (Baltimore) 2018; 97:e13030. [PMID: 30407297 PMCID: PMC6250527 DOI: 10.1097/md.0000000000013030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Endoscopic thyroidectomy (ET) via an axillo-breast (ABA), axillary or breast approach (BA) is effective for treatment of unilateral papillary thyroid microcarcinoma (PTMC). However, several disadvantages still exist, including inconvenience for using endoscopic instruments and poor cosmetic results. Here, we introduced a modified ABA (MABA) to overcome these disadvantages and evaluated its therapeutic outcomes by comparison with conventional BA.Fifty-five patients undergoing ET via MABA (n = 22) or BA (n = 33) for PTMC were retrospectively enrolled between June 2012 and June 2015. Surgical outcomes, including the operation time, blood loss, amount of drainage, number of dissected lymph nodes, complications, cosmetic satisfaction and prognosis (recurrence and survival), were analyzed.The operation time (87.1 ± 9.3 min vs 93.2 ± 8.3 min; P = .014) and drainage tube removal time (4.4 ± 1.0 days vs 5.1 ± 1.1 days; P = .018) were shorter in the MABA group than those in the BA group. There was less postoperative drainage (54.3 ± 35.7 mL vs 137.6 ± 87.0 mL; P < .01) in the MABA group compared with the BA group. No significant differences in the blood loss (15.9 ± 7.5 mL vs 19.2 ± 11.7 mL, P = .243) and the number of dissected lymph nodes (1.8 ± 1.5 vs 2.3 ± 2.1, P = .309) were observed between the 2 groups. Subcutaneous ecchymosis occurred more frequently in the BA group than that in the MABA group (33.3% vs 9.1%; P = .038). Patients treated by MABA were more satisfied with their cosmetic results than those undergoing BA (100% vs 81.8%; P = .034). At the last follow-up time, all patients were alive although 1 patient in the BA group developed cervical lymph node recurrence ipsilateral to the original tumor at 4 years after surgery. Multivariate logistic regression analysis showed MABA surgery was a protective factor for postoperative complications (OR = 0.209, 95% confidence interval [CI] = 0.054-0.817, P = .024).ET via the MABA strategy may be a good choice for unilateral PTMC because of shorter operation time, fewer complications, greater cosmetic satisfaction, and excellent prognosis.
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Tae K, Ji YB, Song CM, Ryu J. Robotic and Endoscopic Thyroid Surgery: Evolution and Advances. Clin Exp Otorhinolaryngol 2018; 12:1-11. [PMID: 30196688 PMCID: PMC6315214 DOI: 10.21053/ceo.2018.00766] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 08/03/2018] [Indexed: 12/13/2022] Open
Abstract
To minimize surgical morbidity and neck scarring, minimally invasive thyroidectomy and robotic/endoscopic thyroidectomy via cervical, axillary, anterior chest, breast, postauricular or transoral approaches have been developed over the past 20 years. In this article, we review the evolution of robotic and endoscopic thyroid surgery and recent advances. Among remote access approaches, the gasless transaxillary approach, bilateral axillo-breast approach, postauricular facelift approach, and transoral vestibular approach are in common use today. Each procedure has its own advantages and disadvantages. Therefore, we need to understand these advantages and limitations, and to select the appropriate method for each patient. The most significant advantage of remote access thyroidectomy is its excellent cosmesis. The complication rate is similar in patients undergoing a remote access approach and those undergoing conventional surgery if the former is performed by experienced surgeons. Operative time is significantly longer in remote access thyroidectomy. In conclusion, remote access thyroidectomy is feasible and its outcomes are comparable to those of conventional transcervical thyroidectomy in highly selected patients.
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Affiliation(s)
- Kyung Tae
- Department of Otolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Yong Bae Ji
- Department of Otolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Chang Myeon Song
- Department of Otolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Junsun Ryu
- Department of Otolaryngology-Head and Neck Surgery, Center for Thyroid Cancer, National Cancer Center, Goyang, Korea
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Reunmarkkaew D, Sittitrai P. Endoscopic Thyroid Lobectomy via Axillary-Breast-Shoulder Approach versus Open Thyroid Lobectomy. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/ss.2018.91002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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17
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Lee MC, Park H, Lee BC, Lee GH, Choi IJ. Comparison of quality of life between open and endoscopic thyroidectomy for papillary thyroid cancer. Head Neck 2015; 38 Suppl 1:E827-31. [DOI: 10.1002/hed.24108] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2015] [Indexed: 01/02/2023] Open
Affiliation(s)
- Myung Chul Lee
- Department of Otolaryngology-Head and Neck Surgery; Korea Cancer Center Hospital; Seoul Korea
| | - Hoon Park
- Department of Otolaryngology-Head and Neck Surgery; Korea Cancer Center Hospital; Seoul Korea
| | - Byeong-Cheol Lee
- Department of Otolaryngology-Head and Neck Surgery; Korea Cancer Center Hospital; Seoul Korea
| | - Guk-Haeng Lee
- Department of Otolaryngology-Head and Neck Surgery; Korea Cancer Center Hospital; Seoul Korea
| | - Ik Joon Choi
- Department of Otolaryngology-Head and Neck Surgery; Korea Cancer Center Hospital; Seoul Korea
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18
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Nationwide multicenter survey for current status of endoscopic thyroidectomy in Korea. Clin Exp Otorhinolaryngol 2015; 8:149-54. [PMID: 26045914 PMCID: PMC4451540 DOI: 10.3342/ceo.2015.8.2.149] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 02/05/2014] [Accepted: 02/17/2014] [Indexed: 02/05/2023] Open
Abstract
Objectives We evaluated the current status of endoscopic thyroidectomy procedures in Korea in terms of indications, contraindications, advantages, disadvantages, complications, and limitations of each approach. Methods An email survey, consisting of 15 questions, was sent to 29 experienced endoscopic thyroidectomy surgeons. Results The most commonly used approach was the gasless transaxillary approach (66.7%), followed by the bilateral axillo-breast approach with gas insufflation (23.8%). The most common indication was less than 1 cm, single papillary thyroid cancer. The role of endoscopic thyroidectomy is not still established; some consider it a novel procedure (34.8%), others a transition to robotic thyroidectomy (34.8%). Conclusion Our results shed light on the general consensus of opinions about endoscopic thyroidectomy, such as the advantages, disadvantages, complications, limitations, and even its future role.
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Lee MC, Park H, Choi IJ, Lee BC, Lee GH. Comparative study of a gasless transaxillary approach versus a bilateral axillo-breast approach for endoscopic thyroidectomy in a single institute. Head Neck 2013; 36:702-8. [PMID: 23606356 DOI: 10.1002/hed.23349] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 02/01/2013] [Accepted: 04/09/2013] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Gasless transaxillary approach (TA) and the bilateral axillo-breast approach (BABA) are 2 distinctive approaches for endoscopic thyroidectomy. The purpose of this study was to evaluate and compare these 2 procedures. METHODS From May 2008 to July 2011, we performed endoscopic hemithyroidectomy via gasless TA (83 cases) and BABA (45 cases). The following variables were evaluated: operation time, postoperative pain score, drainage amount, drainage day, postoperative complications, and cosmetic satisfaction score. RESULTS There were no significant differences between the 2 approaches in terms of clinicopathologic characteristics and surgical outcomes, except for postoperative pain and cosmetic satisfaction. As for postoperative pain and cosmetic satisfaction, the gasless TA group complained of less pain and the BABA group had a better cosmetic outcome. CONCLUSION These findings will contribute to providing guidelines for the choice of surgeons between gasless TA and BABA techniques for endoscopic thyroidectomy.
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Affiliation(s)
- Myung-Chul Lee
- Department of Otorhinolaryngology, Korea Cancer Center Hospital, Seoul, Korea
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