Endoscopic thyroidectomy versus conventional open thyroidectomy for early differentiated thyroid cancer

Abstract

Introduction: Endoscopic thyroidectomy has been applied prudently for malignant thyroid tumors. The aim of our study was to compare the outcomes of endoscopic lobectomy and conventional open lobectomy for early differentiated thyroid cancer. Materials and Methods: From October 2018 to October 2019, 485 patients with early differentiated thyroid cancer underwent thyroid lobectomy in National hospital of Endocrinology enrolled. Of them, 235 patients underwent endoscopic lobectomy (EL) and 250 patients underwent conventional open lobectomy (OL). Results: The mean age of the patients was lower in the EL group (22,3 ± 3,6 years) than in the OL group (31,0 ± 5,8 years, P = 0,013). The ratio female/male was higher in the EL group than in the OL group (12/1 vs 7/1, P = 0,002). The operation time in the EL group was longer than in the OL group (58,4 ± 12,9 vs 42,3 ± 9 minutes, P = 0,014). However, there was no significant differences between EL group and OL group in tumor size (1,2 ± 0,2 vs 1,1 ± 0,6, P = 0,123), blood loss (12,5 ± 0,9 vs 13,6 ± 1,6ml, P = 0,457), postoperative hospital day (4,35 ± 1,4 vs 4,1 ± 1,1 days, P = 0,061), transient hypoparathyroidism (0,85% vs 0,8%, P = 0,431) or transient recurrent laryngeal nerve injury (1,27% vs 1,2%, P = 0,311). The drainage volume in the EL group was higher than in the OL group (75,5 ± 11,4 vs 54,1 ± 10,1ml, P = 0,046). Postoperative bleeding was similar in two groups (0,42% vs 0,4%, P = 0,457). There was no postoperative complications such as permanent recurrent laryngeal nerve injury, tracheal perforation, conversion to open surgery, chyle leak, surgical site infection. Patients in the EL group experienced with less pain than those in the OL group at 1 and 2 days after operation according to a visual analog scale (VAS) (P = 0,047). Wound site numbness is significantly less pronounced in the OL group (p = 0,032). Cosmetically, patients in the EL group were more satisfied than in OL group according to the questionnaire we used (P = 0,021). Conclusions: Endoscopic thyroidectomy for patients with early differentiated thyroid cancer is a safe and effective procedure with excellent cosmetic outcome. Postoperative hospital length stays and complications were similar to conventional open surgery.