A retrospective analysis of 200 axillary route thyroidectomy cases

Abstract

Background: Thyroid disorders are common in women. The surgical solution available in most places is open thyroidectomy, which can ultimately lead to unsightly scar formation. This can be cosmetically unappealing, especially for women. The endoscopic thyroidectomy is a very good alternative to the traditional open thyroidectomy. It gives excellent cosmetic outcomes, especially when done with an axillary approach, without compromising safety. Methodology: This is a retrospective study conducted on 200 patients who underwent endoscopic thyroidectomy at Sunrise Group of Hospitals, Kochi and Dubai, from July 2013 to March 2016. The procedures performed were total thyroidectomy and hemithyroidectomy. The operation time, thyroid gland/nodule size, duration of hospital stay, and complications were considered for the outcome assessment. Results: A total of 200 endoscopic thyroidectomies were done. The mean age was 38 years, and the mean size of the thyroid was 9.19 ± 3.45 cm. The average time for hemithyroidectomy was 90 ± 12 min, and average time for total thyroidectomy was 150 ± 10 min. Forty-two patients underwent endoscopic hemithyroidectomy, whereas 158 patients underwent endoscopic total thyroidectomy. The histopathological reports revealed that there were 70 adenomas, 41 colloid nodules, 30 thyrotoxicosis, 27 thyroiditis, 26 carcinoma, and 6 Hurthle cell neoplasm cases. Complications, such as permanent hypoparathyroidism, nerve injury, and mortality, were not seen in the study population. Conclusion: Endoscopic thyroidectomy offers excellent cosmetic outcomes with no additional untoward effects. This procedure can be utilized for thyroids as large as 12 cm. All pathologies, including malignancies, can be safely dealt by expert endoscopic surgeon.