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ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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4/2019
vol. 14
 
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abstract:
Original paper

A comparison of transoral vestibular and bilateral areolar endoscopic thyroidectomy approaches for unilateral papillary thyroid microcarcinomas

Zhiliang Xu
1
,
Junlong Song
1
,
Yuan Wang
1
,
Lingzhen Tan
1
,
Shengrong Sun
1
,
Yanyan Meng
2

  1. Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, China
  2. Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
Videosurgery Miniinv 2019; 14 (4): 501–508
DOI: https://doi.org/10.5114/wiitm.2019.84759
Online publish date: 2019/04/29
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Introduction
A transoral (TO) vestibular approach is a new remote access approach to avoid cutaneous scars in an endoscopic thyroidectomy (ET). And transoral endoscopic thyroidectomy (TOET) has been widely used in papillary thyroid microcarcinomas (PTMCs).

Aim
To evaluate and compare endoscopic thyroidectomies with central neck dissection using a bilateral areolar (BA) approach and TO approach in patients with unilateral PTMCs.

Material and methods
In total, 92 papillary thyroid cancer (PTC) patients undergoing an endoscopic unilateral thyroidectomy with central neck dissection via a TO (n = 48) or BA (n = 44) approach were retrospectively enrolled from August 2017 to December 2018. Differences in various factors, such as clinical characteristics, surgery-related parameters, including operative complications, and hospital durations and costs, were compared.

Results
No significant between-group differences in the age and sex of the patients or the side, body mass index, total operative time, operative bleeding, superior parathyroid preservation in situ, operative complications, and postoperative day of discharge were found (all p > 0.05). The mean central neck dissection time, amount of postoperative drainage, extubation time, and inferior parathyroid preservation in situ were lower in the TO group as compared with these parameters in the BA group (all p < 0.05). The number of central lymph nodes resected and hospitalization costs were higher in the TO group as compared with those in the BA group (all p < 0.05).

Conclusions
An ET via the TO approach may be a good choice for unilateral PTMCs because of the shorter central neck dissection time, reduced postoperative drainage, better cosmetic satisfaction, and higher number of lymph nodes removed.

keywords:

transoral, bilateral areola, endoscopic thyroidectomy, papillary thyroid cancer, central neck dissection
  
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