Top

Published in:

01-01-2015 | Dynamic Manuscript

Endoscopic thyroidectomy via areola approach: summary of 1,250 cases in a single institution

Authors: Cunchuan Wang, Zhiqi Feng, Jinyi Li, Wah Yang, Hening Zhai, Nim Choi, Jingge Yang, Youzhu Hu, Yunlong Pan, Guo Cao

Published in: Surgical Endoscopy | Issue 1/2015

Abstract

Background

The aim of this study was to evaluate the effect and cosmetic results of endoscopic thyroidectomy (ETE) via the areola approach for patients with thyroid diseases.

Methods

A total of 1,250 patients with thyroid diseases underwent ETE via the areola approach between April 2005 and January 2011. Of these, 898 were benign goiters, 260 were Graves’ disease, 28 were secondary hyperthyroidism, and 64 were papillary carcinomas.

Results

The surgery was successfully completed in 1,249 cases, and 1 case was converted to open surgery. The mean operation time, estimated blood loss, and hospital stay after surgery for patients with a goiter, hyperthyroidism, and papillary carcinoma were 94.4 min, 15.2 ml, 5.0 days, 97.9 min, 16.1 ml, 5.5 days, and 134.3 min, 18.6 ml, 6.4 days, respectively. Complications included 4 cases of postoperative bleeding, 1 case of transection of the recurrent laryngeal nerve (RLN) on one side, 7 cases of temporary RLN injury, 34 cases of transient hypocalcemia, 5 cases of skin bruising on the chest wall, and 1 case of subcutaneous infection in the neck. At 4.6-year (2.5–8 years) follow-up of 1,185 (94.8 %) patients, 3 patients with Graves’ disease had recurrence of hyperthyroidism, and 4 patients with nodular goiter had recurrence of small nodules. Four patients had discomfort on swallowing, 4 patients had an abnormal sensation of skin traction on the neck and the chest, and 1 patient with scar diathesis had mild scar hyperplasia. A total of 876 patients were satisfied, 4 equivocal, and 0 unsatisfied with the cosmetic results.

Conclusion

ETE via the areola approach for patients with benign goiters, Graves’ disease, secondary hyperthyroidism, and papillary carcinomas without metastasis to lateral cervical lymph nodes is an effective and safe procedure with excellent cosmetic results.

Available only for authorised users

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

Huscher CS, Chiodini S, Napolitano C, Recher A (1997) Endoscopic right thyroid lobectomy. Surg Endosc 11:877PubMedCrossRef

Miccoli P, Berti P, Raffaelli M, Conte M, Materazzi G, Galleri D (2001) Minimally invasive video-assisted thyroidectomy. Am J Surg 181:567–570PubMedCrossRef

Shimizu K, Akira S, Tanaka S (1998) Video-assisted neck surgery: endoscopic resection of benign thyroid tumor aiming at scarless surgery on the neck. J Surg Oncol 69:178–180PubMedCrossRef

Ikeda Y, Takami H, Sasaki Y, Kan S, Niimi M (2000) Endoscopic neck surgery by the axillary approach. J Am Coll Surg 191:336–340PubMedCrossRef

Ohgami M, Ishii S, Arisawa Y, Ohmori T, Noga K, Furukawa T, Kitajima M (2000) Scarless endoscopic thyroidectomy: breast approach for better cosmesis. Surg Laparosc Endosc Percutan Tech 10:1–4PubMed

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

Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, Mazzaferri EL, McIver B, Pacini F, Schlumberger M, Sherman SI, Steward DL, Tuttle RM, Ata (2009) Revised American Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 19:1167–1214PubMedCrossRef

Smith BR, Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, Mazzaferri EL, McIver B, Sherman SI, Tuttle RM, Amer Thyroid Assoc Guidelines Taskforce (2006) Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 16:109CrossRef

10.

Singer PA, Cooper DS, Daniels GH, Ladenson PW, Greenspan FS, Levy EG, Braverman LE, Clark OH, McDougall IR, Ain KV, Dorfman SG (1996) Treatment guidelines for patients with thyroid nodules and well-differentiated thyroid cancer. American Thyroid Association. Arch Intern Med 156:2165–2172PubMedCrossRef

11.

12.

Miccoli P, Minuto MN, Ugolini C, Pisano R, Fosso A, Berti P (2008) Minimally invasive video-assisted thyroidectomy for benign thyroid disease: an evidence-based review. World J Surg 32:1333–1340PubMedCrossRef

13.

Wang C-c, Yang J-g, Hu Y-z, Chen J, Xu P, Su C (2007) Endoscopic thyroidectomy via chest and breasts approach in 500 cases. Zhonghua er bi yan hou tou jing wai ke za zhi = Chin J Otorhinolaryngol Head Neck Surg 42:919–923

14.

Maeda S, Uga T, Hayashida N, Ishigaki K, Furui J, Kanematsu T (2006) Video-assisted subtotal or near-total thyroidectomy for Graves’ disease. Br J Surg 93:61–66PubMedCrossRef

15.

Shimizu K, Tanaka S (2003) Asian perspective on endoscopic thyroidectom—a review of 193 cases. Asian journal of surgery/Asian Surgical Association 26:92–100PubMedCrossRef

16.

Yamamoto M, Sasaki A, Asahi T, Shimada Y, Sato N, Nakajima J, Mashima R, Saito K (2001) Endoscopic subtotal thyroidectomy for patients with Graves’ disease. Surg Today 31:1–4PubMedCrossRef

17.

Sasaki A, Nitta H, Otsuka K, Obuchi T, Kurihara H, Wakabayashi G (2009) Endoscopic subtotal thyroidectomy: the procedure of choice for graves’ disease? World J Surg 33:67–71PubMedCrossRef

18.

Li ZY, Wang P, Wang Y, Xu SM, Cao LP, Que RS (2010) Endoscopic thyroidectomy via breast approach for patients with graves’ disease. World J Surg 34:2228–2232PubMedCrossRef

19.

Wilhelm SM, McHenry CR (2010) Total thyroidectomy is superior to subtotal thyroidectomy for management of graves’ disease in the United States. World J Surg 34:1261–1264PubMedCrossRef

20.

Stalberg P, Svensson A, Hessman O, Akerstrom G, Hellman P (2008) Surgical treatment of Graves’ disease: evidence-based approach. World J Surg 32:1269–1277PubMedCrossRef

21.

Ku CF, Lo CY, Chan WF, Kung AWC, Lam KSL (2005) Total thyroidectomy replaces subtotal thyroidectomy as the preferred surgical treatment for Graves’ disease. Anz J Surg 75:528–531PubMedCrossRef

22.

Sugino K, Ito K, Nagahama M, Kitagawa W, Shibuya H, Ito K (2008) Surgical management of Graves’ disease—10-year prospective trial at a single institution. Endocr J 55:161–167PubMedCrossRef

23.

Dogan L, Karaman N, Yilmaz KB, Ozaslan C, Atalay C (2011) Total thyroidectomy for the surgical treatment of multinodular goiter. Surg Today 41:323–327PubMedCrossRef

24.

Albayrak Y, Demiryilmaz I, Kaya Z, Aylu B, Guzel IC, Ozcan O, Aslan S, Yenisolak A, Ozturk M, Celik S (2011) Comparison of total thyroidectomy, bilateral subtotal thyroidectomy and Dunhill operations in the treatment of benign thyroid disorders. Minerva Chir 66:189–195PubMed

25.

Agarwal G, Aggarwal V (2008) Is total thyroidectomy the surgical procedure of choice for benign multinodular goiter? An evidence-based review. World J Surg 32:1313–1324PubMedCrossRef

26.

Bhattacharyya N (2003) Surgical treatment of cervical nodal metastases in patients with papillary thyroid carcinoma. Arch Otolaryngol Head Neck Surg 129:1101–1104

27.

Kandil EH, Noureldine SI, Yao L, Slakey DP (2012) Robotic transaxillary thyroidectomy: an examination of the first one hundred cases. J Am Coll Surg 214:558–564PubMedCrossRef

28.

Ryu HR, Kang S-W, Lee SH, Rhee KY, Jeong JJ, Nam K-H, Chung WY, Park CS (2010) Feasibility and safety of a new robotic thyroidectomy through a gasless, transaxillary single-incision approach. J Am Coll Surg 211:e13–e19PubMedCrossRef

29.

Wang C, Zhai H, Liu W, Li J, Yang J, Hu Y, Huang J, Yang W, Pan Y, Ding H (2014) Thyroidectomy: a novel endoscopic oral vestibular approach. Surgery 155:33–38PubMedCrossRef

Title: Endoscopic thyroidectomy via areola approach: summary of 1,250 cases in a single institution
Authors: Cunchuan Wang
Zhiqi Feng
Jinyi Li
Wah Yang
Hening Zhai
Nim Choi
Jingge Yang
Youzhu Hu
Yunlong Pan
Guo Cao
Publication date: 01-01-2015
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 1/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-014-3658-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Endoscopic thyroidectomy via areola approach: summary of 1,250 cases in a single institution

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2015

Hysterectomy via transvaginal natural orifice transluminal endoscopic surgery for nonprolapsed uteri

Laparoscopic ileo-cecal resection: the total retro-mesenteric approach

The impact of intra-operative interruptions on surgeons’ perceived workload: an observational study in elective general and orthopedic surgery

A prospective, randomized, controlled trial of the postoperative analgesic effects of spraying 0.25 % levobupivacaine after bilateral axillo-breast approach robotic thyroidectomy

Single port/incision laparoscopic surgery compared with standard three-port laparoscopic surgery for appendicectomy: a randomized controlled trial

Predictive factors of recurrence after surgical treatment for liver hydatid cyst