Endoscopic Thyroid Surgery Through the Axillo-Bilateral-Breast Approach

Shimazu, Kenzo; Shiba, Eiichi; Tamaki, Yasuhiro; Takiguchi, Shuji; Taniguchi, Eiji; Ohashi, Satoshi; Noguchi, Shinzaburo

doi:10.1097/00129689-200306000-00011

Cited by 260 publications

(216 citation statements)

References 13 publications

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“…The mean intraoperative blood loss was significantly higher in the OT group although we used the same instrument in coagulation and cutting. The blood loss in the ET via ABS group was 36 mL which was comparable to the previous reports (30 mL of Irawati [13] and 53 mL of Shimazu et al [10]). The average amount of postoperative drainage was significantly more in the ET via ABS group than in the OT group (173 mL vs. 84 mL).…”

Section: Discussionsupporting

confidence: 88%

“…The mean operative time was 116 min in the OT group and 114 min in the ET via ABS group and we had a slightly shorter operative time in the ET via ABS group when compared to the previous reports of the same approach (121 min of Lee et al [12] and 120 min of Irawati [13]) and obviously shorter when compared with the other combined axilla and breast approaches (188 min of Shimazu et al [10] and 154 min of Koh et al [11]). The mean intraoperative blood loss was significantly higher in the OT group although we used the same instrument in coagulation and cutting.…”

Section: Discussioncontrasting

confidence: 51%

“…Although the axillobilateral-breast approach which was introduced by Shimazu et al [10] has favorable cosmetic results and easy instrumentation, three large incisions for 10-mm trocar are required and extensive subcutaneous dissection under the anterior chest wall. Koh et al [11] developed a unilateral axillo-breast approach without gas insufflation that produced relatively good cosmetic results without the side effects of CO 2 but required a larger skin flap elevation and longer axillary incision.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic Thyroid Lobectomy via Axillary-Breast-Shoulder Approach versus Open Thyroid Lobectomy

Reunmarkkaew¹,

Sittitrai²

2018

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Introduction: The aim of the study was to compare the feasibility and safety of endoscopic thyroid lobectomy via axillary-breast-shoulder approach (ET via ABS) with a conventional open thyroid lobectomy (OT). Methods: From November 2014 to December 2015, 20 patients with unilateral benign thyroid nodules were treated with ET via ABS and another 20 patients were treated with an OT. We analyzed the clinical characteristics postoperative complications, pain, and patient satisfaction. Results: No statistically significant differences occurred between groups except the mean ages of the OT group and the ET via ABS group were 55 and 44 years, respectively (p = 0.015). The mean operative time was almost the same in both groups (116 min in the OT group and 114 min in the ET via ABS group). Blood loss was significantly higher in the OT group than in the ET via ABS group (p = 0.042) but postoperative drainage was detected more in the ET via ABS group (p < 0.001). Early postoperative pain was significantly less in the ET via ABS group (p = 0.026). The hospital stay was three days in OT group and four days in ET via ABS group (p = 0.909). Postoperative complications such as hematoma, hoarseness, dysphagia, and prolonged subcutaneous emphysema were detected only in the ET via ABS group but without statistical difference. More patients were "very satisfied" with the treatment in the ET via ABS group than in the OT group. Conclusion: The ET via ABS is as safe and effective as the OT for patients with unilateral thyroid nodules. With less early postoperative pain and higher patient satisfaction, this endoscopic thyroidectomy approach should be considered in patients who concern about cosmetic results.

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Section: Discussionsupporting

confidence: 88%

Section: Discussioncontrasting

confidence: 51%

Section: Introductionmentioning

confidence: 99%

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Endoscopic Thyroid Lobectomy via Axillary-Breast-Shoulder Approach versus Open Thyroid Lobectomy

Reunmarkkaew¹,

Sittitrai²

2018

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“…[8][9][10][11] Many variations of endoscopic thyroidectomy have been described in terms of port placement in the literature. 12,13 These can be grouped into those that use small cervical incisions, either ventral or lateral, and those that use the distant chest wall and periareolar, axillary, or combined approaches. 5,8,[14][15][16][17][18][19] Our approach was using contralateral breast and axillary approach using same instruments as in conventional laparoscopy.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Thyroidectomy—Preliminary Experience from a Tertiary Care Center in Delhi, India

Aggarwal¹,

Raja²,

Garg³

et al. 2017

US Endocrinology

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C osmesis after thyroid surgery has always been a concern for patients approaching thyroid surgery. To achieve a scarless surgery in the neck, endoscopic thyroidectomy using different techniques has been described in the literature. The aim of this article is to study the feasibility of endoscopic combined axillary breast approach for thyroid surgery. This is a retrospective study in the department of Endocrine Surgery from a tertiary care center in Delhi, India. Patients who underwent endoscopic thyroidectomy at our center during May 2010-November 2015 were included. The procedure was carried out in subjects who opted for the procedure with unilateral thyroid nodules of size less than 4 cm, with benign and indeterminate cytology, and with no previous neck surgery or radiation to the neck. The details of demographic profile, operative parameters, and postoperative management were collected for all the cases. All 12 subjects were females. The mean age of the subjects was 27.2 (range 14-45) years. Mean operative time was 187 (range 110-232) minutes. There was a temporary recurrent laryngeal nerve injury in one case, local wound infection in two cases, prolonged subcutaneous emphysema in five cases, and prolonged analgesic requirement (>5 days) in 10 cases. No life-threatening complications were seen in any of the subjects. Cosmetic results were excellent as there was no visible scar in the neck. The combined breast axillary approach using endoscopic technique for unilateral thyroid nodule is feasible with acceptable morbidity and can be offered to selected patients for cosmetic advantage. KeywordsEndoscopic thyroidectomy, minimally invasive thyroidectomy, thyroid nodule Disclosure: Vivek Aggarwal, Bhanu Kiran Raja, Monika Garg, Deepak Khandelwal, and Bhoopendra Agarwal have nothing to declare in relation to this article. No funding was received for the publication of this article.Compliance with Ethics: All procedures were followed in accordance with the responsible committee on human experimentation and with the Helsinki Declaration of 1975 and subsequent revisions.Authorship: All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published.Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any non-commercial use, distribution, adaptation and reproduction provided the original author(s) and source are given appropriate credit. Ever since thyroid surgery has been described, there is ongoing evolution in the surgical techniques of thyroidectomy. The development aims at increasing safety and improving cosmesis.To achieve safety, surgeons have adopted a number of new technologies such as intraoperative neuromonitoring of recurrent laryngeal nerve (RLN), postoperative parathyroid hormone (PTH) assay, and alternative energy devices such as ultrasonic shears or bipolar coa...

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“…The ET techniques can be broadly divided into mini-incision minimally invasive, video-assisted gasless, and purely endoscopic with gas-insufflation methods [4]. According to anatomical access, ET can be performed through cervical, extracervical (chest wall, transaxillary), or combined approaches [7][8][9]. The obvious advantage of the extracervical approach is absence of visible scar in the neck and upper chest.…”

Section: Discussionmentioning

confidence: 99%

Operative Technique of Endoscopic Thyroidectomy: A Narration of General Principles

Bhargav

Vennapusa²

2012

Indian J Surg

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Endoscopic thyroidectomy is fast becoming a reality with increasing experience in endocrine surgery. Many techniques of minimally invasive video-assisted thyroidectomy through cervical and extra-cervical routes such as chest wall, transaxillary, trans-oral, post-auricular, transluminal approach have been attempted. At present anterior chest wall or trans-axillary routes are favourite extracervical routes. In this context, we describe our operative technique of endoscopic thyroidectomy through chest wall to highlight the surgical steps of practical importance.

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Endoscopic Thyroid Surgery Through the Axillo-Bilateral-Breast Approach

Cited by 260 publications

References 13 publications

Endoscopic Thyroid Lobectomy via Axillary-Breast-Shoulder Approach versus Open Thyroid Lobectomy

Endoscopic Thyroid Lobectomy via Axillary-Breast-Shoulder Approach versus Open Thyroid Lobectomy

Endoscopic Thyroidectomy—Preliminary Experience from a Tertiary Care Center in Delhi, India

Operative Technique of Endoscopic Thyroidectomy: A Narration of General Principles

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