Comparative Study of Unilateral Axillo-Breast Approach with Gas Insufflation Versus Gasless Transaxillary Approach for Endoscopic Thyroidectomy in a Single Institute

Abstract

Background and Objectives There have been various approaches introduced for endoscopic thyroidectomy. This study evaluates and compares the surgical outcomes of two such approaches: the unilateral axillo-breast approach (UABA) with gas and the gasless transaxillary approach (TA). Subjects and Method We retrospectively analyzed 279 patients who underwent endoscopic thyroidectomy via UABA with gas or gasless TA from March 2008 to August 2012. Studied variables were clinicopathologic data, surgical outcomes, complications, and cosmetic satisfactions. Results Of the 279 patients, 195 (69.9%) underwent UABA with gas and 84 (30.1%) underwent gasless TA. All of the variables related to clinicopathologic characteristics showed no significant differences between the two groups. The mean operation time was significantly shorter in the UABA with gas group (131.76±44.37 min) than in the gasless TA group (191.01±55.90 min) (p＜0.001). The mean postoperative pain Visual Analogue Scale scores in the UABA with gas group were 2.61±0.96 and 1.85±0.79, respectively, and those in the gasless TA group were 3.12±1.02 and 2.17±0.76, respectively, at 1 and 3 days after surgery. Incidences of postoperative complications were similar except for the higher rate of seroma in the gasless TA group. Cosmetic satisfaction scores of UABA with gas were higher than those of the gasless TA. Conclusion UABA with gas may be a good option for endoscopic thyroidectomy because this approach is less invasive than the gasless TA is. Key words: Endoscopy ㆍ Surgery ㆍ Thyroidectomy