Purpose: A conventional thyroidectomy requires a wide transverse incision on the anterior neck, which can cause significant scaring. We developed an endoscopic thyroid lobectomy using the breast approach and a low carbon dioxide pressure in order to produce better cosmetic results. We reports the clinical analysis of endoscopic thyroid lobectomy and compare the result with those from a conventional thyroid lobectomy.
Methods: From July 2003 and December 2004, 55 consecutive patients with benign thyroid nodules, who underwent endoscopic thyroid lobectomy, and 51 consecutive patients with benign thyroid nodules, who underwent a conventional thyroid lobectomy, were retrospectively reviewed. The preoperative diagnosis of the thyroid nodules was performed using high-resolution ultrasonography and fine- needle aspiration cytology. The clinical results of endoscopic thyroid lobectomy were analyzed and compared with those from a conventional thyroid lobectomy.
Results: There were no significant differences between the two groups in terms of the patients’ gender, size of tumor, preoperative diagnosis (follicular tumor/adenomatous nodule), postoperative diagnosis (cancer/benign), level of postoperative discomfort, length of hospital stay. The patients who underwent endoscopic thyroidectomy were significantly younger than those underwent conventional thryoidectomy (37.4±10.3 years vs. 48.8±13.0 years; P＜0.001). The operation time for the endoscopic group was significantly longer than that for the conventional group (171.9±35.6 min vs. 92.5±26.5 min; P＜0.001). The length of closed drainage in the endoscopic group was longer than that in the conventional group (2.8±0.8 days vs. 1.4±1.3 days; P＜0.001). However, these factors did not affect the length of the hospital stay, and the number of intraoperative complications.
Conclusion: Endoscopic thyroid lobectomy using the breast approach and a low carbon dioxide pressure has cosmetic benefits and is a feasible and safe procedure. (J Korean Surg Soc 2005;69:450-454)
|