Top

Published in:

01-03-2011

Clinical Benefits of Scarless Endoscopic Thyroidectomy: An Expert’s Experience

Authors: Zhi-guo Jiang, Wei Zhang, Dao-zhen Jiang, Xiang-min Zheng, Hong-liang Shen, Cheng-xiang Shan, Sheng Liu, Ming Qiu

Published in: World Journal of Surgery | Issue 3/2011

Abstract

Background

By comparison with the conventional surgical approach to thyroidectomy, scarless (in the neck) endoscopic thyroidectomy (SET) has a superior cosmetic result but a very long learning curve. The objective of the present study was to compare surgical outcomes of SET performed by an experienced surgeon with the outcomes of conventional thyroidectomy.

Method

Enrolled in this study were 25 patients who underwent SET and 18 who underwent conventional surgery. Differences in size of tumor, length of incision, duration of operation, volume of blood loss, pathological findings, postoperative pain, complications, and cosmetic result were investigated.

Results

The two groups were well matched. The total length of incisions and volume of blood loss of SET were significantly lower than those of conventional surgery. In addition to the superior cosmetic result, postoperative pain was significantly less severe and rates of hypesthesia or paresthesia and discomfort while swallowing were significantly lower in the endoscopy group.

Conclusions

In experienced hands, SET offers more benefits than the conventional approach, including less postoperative pain and discomfort and a better cosmetic outcome.

Tan CT, Cheah WK, Delbridge L (2008) “Scarless” (in the neck) endoscopic thyroidectomy (SET): an evidence-based review of published techniques. World J Surg 32:1349–1357CrossRefPubMed

Gagner M (1996) Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg 83:875CrossRefPubMed

Ikeda Y, Takami H, Sasaki Y et al (2000) Endoscopic neck surgery by the axillary approach. J Am Coll Surg 191:336–340CrossRefPubMed

Ohgami M, Ishii S, Arisawa Y et al (2000) Scarless endoscopic thyroidectomy: breast approach for better cosmesis. Surg Laparosc Endosc Percutan Tech 10:1–4PubMed

Ikeda Y, Takami H, Sasaki Y et al (2002) Comparative study of thyroidectomies. Endoscopic surgery versus conventional open surgery. Surg Endosc 16:1741–1745CrossRefPubMed

Sasaki A, Nakajima J, Ikeda K et al (2008) Endoscopic thyroidectomy by the breast approach: a single institution’s 9-year experience. World J Surg 32:381–385CrossRefPubMed

Liu S, Qiu M, Jiang DZ et al (2009) The learning curve for endoscopic thyroidectomy: a single surgeon’s experience. Surg Endosc 23:1802–1806CrossRefPubMed

Slotema ET, Sebag F, Henry JF (2008) What is the evidence for endoscopic thyroidectomy in the management of benign thyroid disease? World J Surg 2:1325–1332CrossRef

Wang M, Zhang T, Mao Z et al (2009) Effect of endoscopic thyroidectomy via anterior chest wall approach on treatment of benign thyroid tumors. J Laparoendosc Adv Surg Tech A 19:149–152CrossRefPubMed

10.

Ikeda Y, Takami H, Sasaki Y et al (2003) Clinical benefits in endoscopic thyroidectomy by the axillary approach. J Am Coll Surg 196:189–195CrossRefPubMed

11.

Shimizu K, Kitagawa W, Akasu H et al (2002) Video-assisted minimally invasive endoscopic thyroid surgery using a gasless neck skin lifting method—153 cases of benign thyroid tumors and applicability for large tumors. Biomed Pharmacother 56(Suppl 1):88s–91sCrossRefPubMed

12.

Perigli G, Cortesini C, Qirici E et al (2008) Clinical benefits of minimally invasive techniques in thyroid surgery. World J Surg 32:45–50CrossRefPubMed

13.

Kataoka H, Kitano H, Takeuchi E et al (2002) Total video endoscopic thyroidectomy via the anterior chest approach using the cervical region-lifting method. Biomed Pharmacother 56(Suppl 1):68s–71sCrossRefPubMed

14.

Koh YW, Kim JW, Lee SW et al (2009) Endoscopic thyroidectomy via a unilateral axillo-breast approach without gas insufflation for unilateral benign thyroid lesions. Surg Endosc 23:2053–2060CrossRefPubMed

15.

Ikeda Y, Takami H, Sasaki Y et al (2004) Are there significant benefits of minimally invasive endoscopic thyroidectomy? World J Surg 28:1075–1078CrossRefPubMed

16.

Shimizu K, Tanaka S (2003) Asian perspective on endoscopic thyroidectomy—a review of 193 cases. Asian J Surg 26:92–100CrossRefPubMed

17.

Cho YU, Park IJ, Choi KH et al (2007) Gasless endoscopic thyroidectomy via an anterior chest wall approach using a flap-lifting system. Yonsei Med J 48:480–487CrossRefPubMed

18.

Duncan TD, Rashid Q, Speights F et al (2007) Endoscopic transaxillary approach to the thyroid gland: our early experience. Surg Endosc 21:2166–2171CrossRefPubMed

19.

Abu-Hijleh MF, Roshier AL, Al-Shboul Q et al (2006) The membranous layer of superficial fascia: evidence for its widespread distribution in the body. Surg Radiol Anat 28:606–619CrossRefPubMed

20.

Ishibashi S, Takeuchi H, Fujii K et al (2006) Length of laparotomy incision and surgical stress assessed by serum IL-6 level. Injury 37:247–251CrossRefPubMed

21.

Huang TJ, Hsu RW, Li YY et al (2005) Less systemic cytokine response in patients following microendoscopic versus open lumbar discectomy. J Orthop Res 23:406–411CrossRefPubMed

22.

Schietroma M, Carlei F, Franchi L et al (2004) A comparison of serum interleukin-6 concentrations in patients treated by cholecystectomy via laparotomy or laparoscopy. Hepatogastroenterology 51:1595–1599PubMed

Title: Clinical Benefits of Scarless Endoscopic Thyroidectomy: An Expert’s Experience
Authors: Zhi-guo Jiang
Wei Zhang
Dao-zhen Jiang
Xiang-min Zheng
Hong-liang Shen
Cheng-xiang Shan
Sheng Liu
Ming Qiu
Publication date: 01-03-2011
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 3/2011
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-010-0905-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical Benefits of Scarless Endoscopic Thyroidectomy: An Expert’s Experience

Abstract

Background

Method

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2011

Intraoperative Near-infrared Fluorescent Cholangiography (NIRFC) in Mouse Models of Bile Duct Injury: Reply

Trends in the Surgical Treatment of Ulcerative Colitis over Time: Increased Mortality and Centralization of Care

Disparities in Injury Mortality Between Uganda and the United States: Comparative Analysis of a Neglected Disease

Clinicopathologic Characteristics of Colorectal Cancer Patients with Synchronous and Metachronous Gastric Cancer

Laparoscopic Repeat Resection of Recurrent Hepatocellular Carcinoma

Anatomical Versus Nonanatomical Resection of Colorectal Liver Metastases: Is There a Difference in Surgical and Oncological Outcome?