Abstract
BackgroundVarious incisions and approaches for thyroidectomy have been developed to treat differentiated thyroid cancer (DTC). Supraclavicular oblique incision (SOI) thyroidectomy (SOIT) has been applied in DTC patients over the past ten years. However, the safety and efficacy of this approach were yet to be confirmed.AimThis study aimed to compare the surgical and patient-related outcomes between SOIT and traditional low collar incision thyroidectomy (TLCIT) in patients with DTC.MethodsWe retrospectively screened all patients with DTC who received thyroid lobectomy from October 2020 to October 2021. The surgical results and patient-related outcomes assessed at 1 and 6 months after surgery by questionnaire were compared between the SOIT and TLCIT groups.ResultsA total of 128 patients were included in this study, of whom 38 patients (30.5%) were operated on with SOIT and 89 patients (69.5%) with TLCIT. There was no significant difference in demographic characteristics and thyroid features between the two groups. Despite comparable operative time (61.9 ± 12.1 vs. 59.9 ± 15.0 min, p = 0.425), the SOIT group had a smaller neck incision (4.4 ± 0.7 vs. 5.0 ± 1.0 cm, p = 0.002), a shorter duration of postoperative drainage (2.4 ± 0.5 vs. 2.7 ± 0.9 days, p = 0.019), less volume of postoperative drainage (48.4 ± 24.6 vs. 60.3 ± 22.8 ml, p = 0.040), and shorter postoperative hospitalization (3.2 ± 0.5 vs. 3.6 ± 0.9 days p = 0.006), as compared with the TLCIT group. At 1-month follow-up after surgery, SOIT showed better performance in preventing hypoparathyroidism (p = 0.026) and abnormal neck sensation (p = 0.010) and in improving cosmetic satisfaction (p = 0.036) than TLCIT. At 6-month follow-up, SOIT was feedback with better cosmetic satisfaction (p < 0.001) and a lower percent of abnormal neck sensation (p = 0.031) or movement (p = 0.005).ConclusionOur study suggests that minimally invasive surgery using the SOI provides superior surgical and patient-related outcomes compared with surgery using a traditional low collar incision (TLCI) in patients with DTC.
Highlights
Thyroid cancer is one of the most common endocrine malignancies with an increasing incidence worldwide over the past two decades [1, 2]
This study retrospectively screened all differentiated thyroid cancer (DTC) patients receiving thyroid lobectomy admitted to the Department of General Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, from October 2020 to October 2021
The creation of extensive subcutaneous tunnels may lead to postoperative localized scar growth, and patients are prone to discomfort such as skin tugging
Summary
Thyroid cancer is one of the most common endocrine malignancies with an increasing incidence worldwide over the past two decades [1, 2]. Traditional low collar incision (TLCI) is the conventional surgical approach of thyroidectomy for treating DTCs. the following shortcomings of this approach are found in practice: 1) the surgery space is limited, making it challenging to dissect the superior thyroid vessels, the recurrent laryngeal nerve, and the superior parathyroid glands. The following shortcomings of this approach are found in practice: 1) the surgery space is limited, making it challenging to dissect the superior thyroid vessels, the recurrent laryngeal nerve, and the superior parathyroid glands For this reason, the anterior cervical band is cut sometimes to expose the surgical area more extensively. 2) Traditional surgical approach causes great damage to the neck tissues, leading to postoperative neck tissue edema and scar growth on the anterior neck. Various incisions and approaches for thyroidectomy have been developed to treat differentiated thyroid cancer (DTC). The safety and efficacy of this approach were yet to be confirmed
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