Endoscopic thyroidectomy in China

Excerpt

Endoscopic thyroidectomy (ET) techniques via various approaches have been touted for their cosmetic superiority. This is particularly true for those without any neck scars, such as the anterior chest approach, the breast approach, and the axillary approach. Recently, the Safe Introduction of New Procedures Committee of the Hospital Authority governing all of the 41 public hospitals in the Hong Kong Special Administrative Region of China has received submissions applying for permission to try the breast approach. Having been invited to chair the designated panel, I set out to search the English literature for clinical evidence; however, I could find only one comparative study without randomization (level 2 evidence) and four overlapping case series (level 3 evidence) [1‐5]. The comparative study contained only 10–12 cases in each arm [5]. Also, three of these five publications came from the same university [3‐5]. Given the paucity of published data, the jury seemed undecided about whether to allow its widespread adoption—until recently when I became acutely aware that ET is now commonplace in Mainland China. However, all relevant clinical reports have been written in Chinese. I feel compelled to unveil the current status of ET in China to the wider surgical fraternity based on my on-site observations and the data in the Manual of the 10th National Advanced Course in Endoscopic Thyroidectomy 2008—most aptly in Surgical Endoscopy, a specialty journal of international repute. …