Application of modified endoscopic thyroidectomy via chest and breast areola approach for benign thyroid disease patients

Abstract

Objective To study the safety and feasibility of modified endoscopic thyroidectomy via chest and breast areola approach for benign thyroid disease patients.MethodsA total of 56 female benign thyroid disease patients,who received endoscopic thyroidectomy in our hospital from March 2011 to March 2012,were included in this study.And 28 of them underwent modified endoscopic thyroidectomy(modified group).Taking the advantage of movable female breast and the long rod-shaped endoscopic instrument,the operation was modified based on endoscopic thyroidectomy via chest and breast areola approach,without subcutaneous dissection of the chest wall.Another 28 patients received conventional approach treatment(conventional group).The two groups were matched in mean age and disease causes.The operation time,blood loss,post-operative pain degree,post-operation hospital stay,and complications were compared between the two groups.ResultsThe operation time,blood loss,post-operation hospital stay,and post-operation drainage volume were not significantly different between the two groups.Compared with patients in the conventional group,patients in modified group suffered significantly less post-operation pain,with mean visual analogue scale scores being 3.0±1.6 vs 4.5±1.8(P =0.042).The modified group also had significantly reduced incidence of skin redness and subcutaneous ecchymosis,edema and chance of effusion on the anterior chest wall(0 vs 21.4%,P =0.01).There were no damages to recurrent laryngeal nerve or parathyroid glands or postoperative hemorrhage in the 56 patients.ConclusionThe modified endoscopic thyroidectomy via chest and breast areola approach is a safe and effective method,and it can greatly reduce the trauma of conventional endoscopic thyroidectomy.