Comparative study comparing endoscopic thyroidectomy using the axillary approach and open thyroidectomy for papillary thyroid microcarcinomaReport as inadecuate




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World Journal of Surgical Oncology

, 10:269

First Online: 12 December 2012Received: 23 September 2012Accepted: 26 November 2012

Abstract

BackgroundEndoscopic thyroidectomy has been applied prudently to malignant thyroid tumors. The purpose of our study was to compare the surgical outcomes of endoscopic thyroidectomy ET and conventional open thyroidectomy COT for micropapillary thyroid carcinoma.

MethodsFrom October 2002 to December 2008, 78 patients underwent unilateral lobectomy and isthmectomy with central lymph node dissection for papillary thyroid microcarcinoma. Of these, 37 patients underwent ET and 41patients COT. Surgical outcomes, including operation time, number of retrieved lymph nodes, postoperative complication rate and patients’ satisfaction with the cosmetic results, were analyzed.

ResultsThe mean age of the patients was 42.3 ± 7.6 years in the ET group and 49.0 ± 10.8 years in the OT group P = 0.003. The operation time was shorter in the COT group 112.3 ± 14min than in the ET group 138.4 ± 36.9 min, P< 0.01. However, there were no significant differences in tumor size 0.5 ± 0.231vs. 0.41 ± 0.264cm, P = 0.116, number of retrieved lymph nodes 3.63 ± 2.1vs. 3.82 ± 3.28, P = 0.78 or postoperative hospital stay 3.35 ± 0.94vs. 3.17 ± 1.16 days, P = 0.457. Patients in the ET group experienced more pain than those in the COT group at 1 and 7 days after the operation as evaluated by a visual analog scale P = 0.037, 0.026. Cosmetically, patients in the ET group were very satisfied with the operative procedure according to the questionnaire we used 1.43 ± 0.55vs. 3.21 ± 0.72, P< 0.001. The mean follow-up period was 54.3 months in the ET group and 47.4 months in the COT group, and each group exhibited one case of tumor recurrence detected at the other thyroid lobe within 2 years.

ConclusionsLarge series of prospective studies and long-term follow-up are needed, but the results of ET using the axillary approach for micropapillary thyroid carcinoma were not inferiortothose using COT, and it might be a safe and feasible procedure with good cosmetic results.

KeywordsEndoscopic thyroidectomy Conventional open thyroidectomy Micropapillary thyroid carcinoma Electronic supplementary materialThe online version of this article doi:10.1186-1477-7819-10-269 contains supplementary material, which is available to authorized users.

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Author: Hayemin Lee - Jina Lee - Ki Young Sung

Source: https://link.springer.com/



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