Bilateral areolar approach endoscopic thyroidectomy for low-risk papillary thyroid carcinoma: a review of 137 cases [corrected

Abstract

The aim of this study was to analyze the clinicopathologic characteristics and postoperative outcomes and to evaluate the feasibility of the bilateral areolar approach (BAA) endoscopic thyroidectomy for low-risk papillary thyroid carcinoma (PTC). From January 2012 to February 2013, 137 low-risk PTC patients underwent BAA endoscopic thyroidectomy. Their clinicopathologic characteristics and postoperative outcomes (postoperative cosmetic satisfaction, type of thyroidectomy, number of lymph nodes, postoperative complications, and recurrence of disease) were analyzed. The 137 patients comprised 135 female and 2 male individuals. The average age of patients was 32.02±8.32 years. The mean tumor size was 0.82±0.41 cm. The ratio of minimal extrathyroidal extension patients was 1:19.6. According to the American Joint Committee on Cancer tumor stage, 132 cases were stage I and 5 cases were stage III. The mean follow-up period was 7.80±3.86 months (range, 3 to 15 mo, and median, 7 mo). At 3 months, postoperatively, patients were very satisfied with the cosmetic result as evaluated by a 10-point visual analogue scale (9.14±1.17). After surgery, the mean number of lymph nodes was 5.70±2.92, whereas the mean number of lymph node metastases was 1.06±1.96. Regarding the major postoperative complications, the rates of transient recurrent laryngeal nerve palsy and transient hypoparathyroidism were 4.4% and 27.7%, respectively. None of the patients experienced a thyroid cancer-related death or recurrence. BAA is feasible and safe for the treatment of low-risk PTC patients, with favorable cosmesis. Thus, it is an alternative therapeutic treatment for selected patients with low-risk PTC. However, oncologic safety of BAA thyroidectomy for PTC patients needs to be verified by a large comparative series and long-term follow-up.