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KMID : 0978820070100010045
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Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2007 Volume.10 No. 1 p.45 ~ p.50
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Endoscopic Thyroidectomy by the Axillary Approach for a Bilateral Thyroid Tumor
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Oh Seong-Il
Kim Ji-Il
Baek Jong-Min
Sung Ki-Young
Lee Dong-Ho
Suh Young-Jin
Park Woo-Chan
Lee Do-Sang
Kim Wook
Park Il-Young
Won Jong-Man
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Abstract
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Purpose: The performance of an endoscopic thyroidectomy by the axillary approach produces no scar at either the neck or the chest. However, difficulty in resecting the contralateral thyroid lobe is a continual problem. We evaluated the effectiveness and safety of performing an endoscopic thyroidectomy using the axillary approach for the resection of a bilateral thyroid tumor.
Methods: We reviewed patients that underwent an endoscopic thyroidectomy for a bilateral thyroid tumor between November 2001 and December 2003. During this period, an endoscopic thyroidectomy was attempted in patients with a benign tumor and a micropapillary carcinoma, as confirmed by fine-needle aspiration cytology. Patients with a history of receiving radiation therapy for the neck or patients that received previous neck surgery were excluded from the study.
Results: All patients were women. The mean age of the patients was 40.1±10 years. All endoscopic thyroidectomies were performed by the axillary approach. The surgical types included 45 cases of an endoscopic unilateral lobectomy and a contralateral partial lobectomy, one case of an endoscopic subtotal thyroidectomy of both lobes, and one case of an endoscopic total thyroidectomy. None of the patients required conversion to open surgery. The mean operative time was 172.34±52.64 minutes, and the mean tumor size was 2.97±0.94 cm. Postoperative complications were two cases of a hematoma, one case of a seroma, one case of transient swallowing difficulty and three cases of parethesia. Nevertheless, all patients were satisfied with the cosmetic results. The mean length of hospital stay was 3.26±1.17 days.
Conclusion: We conclude that the use of the endoscopic thyroidectomy by the axillary approach can be an effective and safe procedure for a bilateral thyroid tumor.
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KEYWORD
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Endoscopic thyroidectomy, Axillary approach, Bilateral thyroid tumor
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