Endoscopic central lymph node dissection of thyroid cancer via chest–breast approach: results, indications, and strategies

Sun, Pin; Zhan, Jialin; Chong, Tsz Hong; Li, Jinyi; Wang, Cunchuan

doi:10.1007/s00464-021-08758-7

Cited by 9 publications

(12 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Lymph node clearance is another example of effectiveness. The number of CLND in the breast approach group in this study was 7.4 ± 4.8, which is comparable to the average CLND reported by other scholars [6.15 ± 4.90 (18), 7.3 ± 3.9 (19), and 7.53 ± 0.67 (20)], so it is reasonable to believe that the CLND by the breast approach achieves the same extent of dissection as that reported by scholars both nationally and internationally. However, we observed that the mean number of lymph nodes in the central area of the breast approach group was lower than that of traditional open surgery on the neck [10.87 ± 6.43 (21), 10.71 ± 5.17 (22), 10.1 ± 6.98 (23)].…”

Section: Discussionsupporting

confidence: 88%

Prophylactic central lymph node dissection in cN0 papillary thyroid cancer: a comparative study of via breast and transoral approach versus via breast approach alone

Qiu,

2024

Front. Endocrinol.

View full text Add to dashboard Cite

BackgroundPapillary thyroid cancer (PTC) progresses slowly and has a good prognosis, while the prognosis is worse if combined with central neck lymph node metastasis at an early stage. The different endoscope approaches may affect the thoroughness of lymph node dissection. This study aimed to compare the clinical efficacy and safety of prophylactic central lymph node dissection(CLND) for cN0 PTC performed via breast and transoral approach versus via breast approach alone.Materials and methodsA retrospective analysis of the surgical data of 136 patients with stage cN0 PTC was performed from August 2020 to December 2022. Among them, 64 underwent the breast and transoral approach (combined approach group), and 72 underwent the breast approach alone (breast approach group). The relevant indexes of surgery, the number of lymph nodes dissected, the occurrence of postoperative complications, and the cosmetic satisfaction of incision were statistically compared between the two groups.ResultsThe operation time of the combined approach group was 156.4 ± 29.8 min, significantly longer than that of the breast approach group, 119.6 ± 55.9 min, and the difference was statistically significant (P<0.05). The two groups of patients were compared in terms of intraoperative bleeding, postoperative drainage, hospitalization time, incision cosmetic satisfaction, and the occurrence of postoperative complications, and the differences were not statistically significant (P>0.05). The total number of lymph nodes retrieved in the central area (10.6 ± 7.1) and the number of positive lymph nodes (4.6 ± 4.9) in the combined approach group were significantly more than those in the breast approach group (7.4 ± 4.8, 1.6 ± 2.7), and the difference was statistically significant (P<0.05). The difference between the two groups in terms of the number of negative lymph nodes was not statistically significant (P>0.05).ConclusionsThe study demonstrated that choosing the breast combined transoral approach for prophylactic CLND of cN0 PTC could more thoroughly clear the central area lymph nodes, especially the positive lymph nodes, which could help in the evaluation of the disease and the guidance of the treatment, while not increasing the postoperative complications. It provides a reference for clinicians to choose the appropriate surgical approach and also provides new ideas and methods for prophylactic CLND in patients with cN0 PTC.

show abstract

Section: Discussionsupporting

confidence: 88%

Prophylactic central lymph node dissection in cN0 papillary thyroid cancer: a comparative study of via breast and transoral approach versus via breast approach alone

Qiu,

2024

Front. Endocrinol.

View full text Add to dashboard Cite

show abstract

“…The cosmetic effect of the transoral approach is good, but the operation is the most complex and difficult among the three approaches [ 16 ]. The operation of the transthoracic mammary approach is relatively simple, but scars can still be formed around the chest wall and areola, and the aesthetic effect is noticeable [ 17 ]. However, the transaxillary approach combines the advantages of the above two approaches and avoids their disadvantages.…”

Section: Discussionmentioning

confidence: 99%

Construction of a system for head and neck tumor traceless resection with non-inflatable transaxillary total endoscopic surgery

Sun¹,

Xu²,

Malouta³

et al. 2023

World J Surg Onc

View full text Add to dashboard Cite

Radical cure and functional preservation of tumors are the fundamental goals of surgical treatment of head and neck tumors, and the preservation of good aesthetics is a higher pursuit on this basis. Fully hiding the surgical incision and reducing the visibility of scars are important goals of cosmetic surgery. Using complete endoscopy for the head and neck is an effective method. CO2-free transaxillary total endoscopic surgery is a method with many advantages, which has been widely used in the resection of thyroid tumors, but for other parts and types of tumors in the head and neck, this surgical method is rarely used. The research team expanded its application scope and applied it to submandibular gland tumor resection and other head and neck surgeries for the first time. Through this exploration, it improved traction devices such as retractors, strictly limited the surgical indications, analyzed and summarized the key points, steps and methods of surgery, and built a treatment system for head and neck tumor surgery under complete endoscopy using the non-inflatable transaxillary approach. In this article, we introduce the system and select typical cases to share.

show abstract

“…A propensity score-matching analysis showed that there were no significant differences in the mean number of central lymph nodes retrieved between the TOA group and the COA group (9.39 ± 4.01 versus 10.71 ± 5.17, p = 0.202) ( 59 ). Sun ( 60 ) reported that the number of dissected lymph nodes (7.0 ± 5.3 versus 7.3 ± 3.9, p = 0.681) and the number of metastatic lymph nodes (2.0 ± 2.5 versus 1.8 ± 1.7, p = 0.723) did not differ significantly between COA and CBA groups. He’s research ( 25 ) showed that there was no significant difference in the number of central lymph node removed between COA and BABA (6.7 ± 2.0 versus 6.8 ± 2.1, p > 0.05).…”

Section: Selection Strategymentioning

confidence: 99%

Comparisons of different approaches and incisions of thyroid surgery and selection strategy

et al. 2023

View full text Add to dashboard Cite

To date, the traditional open thyroid surgery via a low collar incision remains the standard approach for patients undergoing thyroidectomy. However, this conventional approach will inevitably leave patients a neck scar and even cause a variety of complications such as paresthesia, hypesthesia, and other uncomfortable sensations. With the progress in surgical techniques, especially in endoscopic surgery, and the increasing desire for cosmetic and functional outcomes, various new approaches for thyroidectomy have been developed to avoid or decrease side effects. Some of these alternative approaches have obvious advantages compared with traditional surgery and have already been widely used in the treatment of thyroid disease, but each has its limitations. This review aims to evaluate and compare the different approaches to thyroidectomy to help surgeons make the proper treatment strategy for different individuals.

show abstract

Endoscopic central lymph node dissection of thyroid cancer via chest–breast approach: results, indications, and strategies

Cited by 9 publications

References 16 publications

Prophylactic central lymph node dissection in cN0 papillary thyroid cancer: a comparative study of via breast and transoral approach versus via breast approach alone

Prophylactic central lymph node dissection in cN0 papillary thyroid cancer: a comparative study of via breast and transoral approach versus via breast approach alone

Construction of a system for head and neck tumor traceless resection with non-inflatable transaxillary total endoscopic surgery

Comparisons of different approaches and incisions of thyroid surgery and selection strategy

Contact Info

Product

Resources

About