Preliminary report on a novel technique for endoscopic transaxillary thyroidectomy: a case-control study.

Abstract

Endoscopic transaxillary approaches to thyroidectomy have been well described and gasless transaxillary endoscopic thyroidectomy (GTET) is the most popular method. However, this require a single long axillary incision which is longer than most remote access thyroidectomy procedures. The authors improved the GTET and provided a novel way to access the thyroid. The purpose of this study was to test the feasibility of our novel transaxillary thyroidectomy procedure and to attempt to reduce the size of the scar and reduce the flap creation area. One hundred sixteen patients who underwent our novel transaxillary thyroidectomy procedure were compared with the patients who underwent open and GTET procedures. The patients' demographics, outcomes, and complications were analyzed. Although the operation time (121.48±23.91mins) was longer in the novel endoscopic group compare to the open group, it was shorter than GTET group. Intraoperative blood loss was similar between the groups. However, the novel procedure group had more drainage volume within 48 postoperative hours compare to other two groups. Despite the VAS pain score did not reveal a difference between the open and novel endoscopic procedure, it was lower in the novel procedure than GTET. The hospital stay days did not show a difference between the two groups. The number of resected central lymph nodes was similar between the groups. Differences did not reveal between the groups regarding to the complications rate. Our results showed that our novel transaxillary thyroidectomy procedure is feasible and safe. This procedure can be an alternative endoscopic transaxillary method for thyroidectomy.