Endoscopic thyroid resection using cutaneous elevation in lieu of insufflation

Kitano, Hiroya; Fujimura, Masaki; Kinoshita, Takashi; Kataoka, Hideyuki; Hirano, Masamitsu; Kitajima, Kazutomo

doi:10.1007/s004640080197

Cited by 88 publications

(64 citation statements)

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“…However, several reports about the application of endoscopic thyroidectomy for PTMC patients in the low-risk group have emerged. Kitano et al [10] reported that indications for endoscopic thyroidectomy in thyroid carcinoma are as follows: (1) age <45 years, (2) tumor size <2 cm, and (3) no evidence of lymph node or local invasion. Miccoli et al [9] showed that there was no difference between conventional open thyroidectomy and endoscopic thyroidectomy in surgical completeness.…”

Section: Discussionmentioning

confidence: 99%

“…In 2002, Miccoli et al [9] attempted to perform endoscopic surgery on patients with papillary thyroid carcinoma [9]. Thereafter, many trials involving endoscopic thyroidectomy for thyroid carcinoma with low-risk patients have been reported [10]. We also introduced a novel method of gasless endoscopic thyroidectomy using a trans-axillary approach and early surgical outcomes of patients with benign and malignant thyroid diseases [11].…”

Section: Introductionmentioning

confidence: 99%

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Comparative study of endoscopic thyroidectomy versus conventional open thyroidectomy in papillary thyroid microcarcinoma (PTMC) patients

Jeong

Kang

Yun

et al. 2009

Journal of Surgical Oncology

136

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Background: The aim of this study was to evaluate and compare the early surgical outcomes of endoscopic and conventional open thyroidectomies in patients with papillary thyroid microcarcinoma (PTMC). Methods: Between September 2005 and December 2007, 499 patients with PTMC were enrolled. 275 patients underwent gasless endoscopic thyroidectomy via the axillary route (endo group), and 224 patients underwent conventional open thyroidectomy (open group). We analyzed the patient's clinico-pathologic characteristics and surgical completeness between the two groups. Results: The endo group was younger than the open group. The open group underwent more extensive surgery than the endo group. The operative time was longer in the endo group than the open group (138.5 AE 49.0 minvs. 105.5 AE 41.6 min; P < 0.0001), and a lesser number of lymph nodes were retrieved in the endo group compared to the open group (5.05 AE 2.94 vs. 5.96 AE 4.50, P ¼ 0.007). We experienced complications in the endo group, such as transient hypocalcemia, transient RLN palsies, tracheal injuries, and esophageal injuries. Therewas no abnormal uptake on RAI scans in the two groups. From among patients who had undergone total thyroidectomy, all patients in the endo group had <1 ng/ml of serum Tg post-operatively; the seven patients in the open group had >1 ng/ml of serum Tg post-operatively. Tumor recurrence was detected in the open group only (n ¼ 6). Also we checked the post-operative Tg in patients who had undergone lobectomy in the two groups, and found that there were no statistical differences in the two groups. Conclusions: According to our experience, gasless endoscopic thyroidectomy using a trans-axillary approach is a safe and feasible alternative to conventional open thyroidectomy in selected patients with PTMC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparative study of endoscopic thyroidectomy versus conventional open thyroidectomy in papillary thyroid microcarcinoma (PTMC) patients

Jeong

Kang

Yun

et al. 2009

Journal of Surgical Oncology

136

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“…It is comparable to open technique and comparable to other series (Table 3). [11][12][13] Mean operative time was 88.19 min. Author calculated the time required for surgery for first 10 cases, next 10 cases and last 6 cases, which decreased sequentially.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic thyroidectomy-axilla breast approach: the experience of 26 cases

et al. 2018

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Background: Conventional thyroidectomy results in transverse scar formation on neck. These scars are uncomfortable and cosmetically unacceptable. Endoscopic thyroidectomy is widely accepted technique in specialized centers. The potential advantages of endoscopic technique include better cosmetic result, decreased hospital stay and better patient comfort. Author started performing endoscopic thyroidectomy at the centre to demonstrate the feasibility of operating thyroid gland endoscopically by axilla breast approach.Methods: Author performed 26 cases of endoscopic thyroidectomy by axilla breast approach from June 2014 to July 2017 in patients presenting with indication for surgical thyroid excision. Author did hemithyroidectomy in 19 patients, total thyroidectomy in 3 patients and near total thyroidectomy in 4 patients. All patients underwent endoscopic thyroidectomy by axilla breast approach by creating subplatysmal space with carbon dioxide insufflation at the pressure of 8 to 10mmHg. Results were compared with the recent studies with comparable number of patients.Results: Author did hemithyroidectomy in 19 patients, total thyroidectomy in 3 patients and near total thyroidectomy in 4 patients. Mean Operative time was 88.19 min. But last 6 cases were completed in 49.60±4.20 min. Thus, as experience increased we tend to complete procedure in progressively lesser time period. Mean blood loss in the series was 21.88ml. Mean Hospital stay was 2.88 days (range 2-5 days). Scar satisfaction on visual analogue scale after 3 months of operation was 9.11. Histopathological examination revealed adenomatous goitre in 24 cases and follicular adenoma in 2 cases.Conclusions: Endoscopic thyroidectomy via axilla breast approach is safe, feasible and minimally invasive surgical method for thyroid diseases, with good post-operative results. Surgeons having adequate training in endoscopic surgery can perform endoscopic thyroidectomy with short learning curve.

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“…Most difficulties can be avoided or overcome thanks to the knowledge built on surgical training and ongoing experience. The learning curve is very steep, but it has been proven that the length of surgery decreases with surgical experience, and may possibly improve with advances in surgical instruments [34].…”

Section: Szkolenie Podyplomowementioning

confidence: 99%

Od preparowania czterogruczołowego do technik małoinwazyjnych. Małoinwazyjna paratyroidektomia jako obecny standard chirurgii pierwotnej nadczynności przytarczyc

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Stróżyk

Proczko-Markuszewska

et al. 2014

Endokrynologia Polska

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Complete surgical resection of hyperfunctioning parathyriod tissue is essential for the treatment of primary hyperparathyroidism. During recent years, minimally invasive surgery has been successfully applied in neck exploration, because of significant developments of guidance by intraoperative scans, the use of quick, intraoperative PTH assay, and also preoperative imaging procedures such as highresolution ultrasonography and sestamibi scintigraphy. The results of operations which are performed with minimally invasive techniques are comparable to those of conventional surgery, and provide advantages with regard to cosmetic result, length of hospitalisation, and reduced post-operative pain. StreszczenieCałkowite chirurgiczne usunięcie nadczynnej tkanki gruczołowej jest kluczowe dla leczenia pierwotnej nadczynności przytarczyc. Podczas ostatnich lat, techniki chirurgii małoinwazyjnej były z sukcesem wprowadzane do preparowania tkanek szyi. Było to możliwe dzięki opracowaniu śródoperacyjnych metod lokalizowania zmienionej tkanki, szybkim testom oznaczającym stężenie PTH w surowiczy, jak również doskonaleniu technik obrazowania przedoperacyjnego, takich jak ultrasonografia wysokiej rozdzielczości czy scyntygrafia z wykorzystaniem sestamibi. Wyniki operacji z wykorzystaniem technik małoinwazyjnych są porównywalne z wynikami technik konwencjonalnych oraz wiążą się z zaletami, takimi jak skrócony okres hospitalizacji, zmniejszenie bólu pooperacyjnego czy lepszy efekt kosmetyczny. (Endokrynol Pol 2014; 65 (3): 240-249) Słowa kluczowe: pierwotna nadczynność przytarczyc; konwencjonalne preparowanie tkanek szyi; minimalnie inwazyjna parathyroidectomia

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Endoscopic thyroid resection using cutaneous elevation in lieu of insufflation

Cited by 88 publications

References 10 publications

Comparative study of endoscopic thyroidectomy versus conventional open thyroidectomy in papillary thyroid microcarcinoma (PTMC) patients

Comparative study of endoscopic thyroidectomy versus conventional open thyroidectomy in papillary thyroid microcarcinoma (PTMC) patients

Endoscopic thyroidectomy-axilla breast approach: the experience of 26 cases

Od preparowania czterogruczołowego do technik małoinwazyjnych. Małoinwazyjna paratyroidektomia jako obecny standard chirurgii pierwotnej nadczynności przytarczyc

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