Gasless endoscopic transaxillary thyroid surgery: CUSUM analysis of a single surgeon’s experience from 105 preliminary procedures

Sun, Botao; Li, Peiting; Cong, Rong; Zhou, Di; Zhang, Zeyu; Xia, Fada; Li, Xinying

doi:10.1007/s00464-022-09273-z

Cited by 10 publications

(6 citation statements)

References 27 publications

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“…The IJV should be carefully dissected to avoid IJV injury, and the lateral neck compartment should be dissected successfully during reoperation. Gasless transaxillary endoscopic thyroid surgery should be performed in strictly selected patients with adequate preoperative assessment ( 5 ).…”

Section: Discussionmentioning

confidence: 99%

“…A 4 cm length incision and an accessary 5 mm incision was made as described by our team. The route to the anterior neck area was dissected and the SCM was exposed ( 5 ). Then the strap muscles were dissected laterally, the omohyoid muscle and IJV were exposed and the retractor was placed beneath the straps muscle to finish working space making ( 5 ).…”

Section: Case Presentationmentioning

confidence: 99%

“…The route to the anterior neck area was dissected and the SCM was exposed ( 5 ). Then the strap muscles were dissected laterally, the omohyoid muscle and IJV were exposed and the retractor was placed beneath the straps muscle to finish working space making ( 5 ). The right lobe and isthmus of the thyroid gland were simultaneously removed for intraoperative frozen section biopsies (FSBs).…”

Section: Case Presentationmentioning

confidence: 99%

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Completion thyroidectomy and lateral neck dissection revealed adhesions in the lateral neck compartment after gasless transaxillary endoscopic thyroidectomy: a case report

Xia

Sun

2022

Gland Surg

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Background: Endoscopic thyroidectomy is effective and safe surgical option for thyroid surgery while providing satisfactory cosmetic results. Gasless transaxillary endoscopic approaches have been reported to achieve endoscopic thyroidectomy in our center.Case Description: We present a patient who previously underwent gasless transaxillary endoscopic lobectomy with ipsilateral central neck dissection who underwent open completion thyroidectomy and lateral neck dissection (LND) (reoperation) in our center. The ultrasound test before the first treatment did not reveal abnormal lymph nodes in the central and lateral neck compartments. Further evaluation of the neck lymph nodes was not performed. Meanwhile, this patient did not participate in the originally planned follow-up at the 3-and 6-month visits. At the one-year visit, imaging tests revealed enlarged and suspicious malignant lymph nodes in levels III and IV of the lateral neck compartments. We believed that reoperation was performed for persistent, rather than truly recurrent disease for this patient. During the second surgery, we found that the surface of internal jugular vein (IJV) was significantly adhered to the surrounding fibroadipose tissue and the omohyoid muscle was adhered to the IJV. After carefully dissected the IJV, the dissection of the lateral neck compartment had been performed successfully.Conclusions: Exposure of the lateral neck compartment in the gasless transaxillary procedure, especially exposure of the IJV, causes adhesions of the lateral neck compartment and brings difficulties for possible future LND. Gasless transaxillary endoscopic thyroid surgery should be performed in strictly selected patients with adequate preoperative assessment. The IJV should be carefully dissected to avoid IJV injury, and the lateral neck compartment could be dissected successfully during reoperation.

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Section: Discussionmentioning

confidence: 99%

Section: Case Presentationmentioning

confidence: 99%

Section: Case Presentationmentioning

confidence: 99%

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Completion thyroidectomy and lateral neck dissection revealed adhesions in the lateral neck compartment after gasless transaxillary endoscopic thyroidectomy: a case report

Xia

Sun

2022

Gland Surg

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“…In a study by Yang et al, the VAS scoring was used to assess pain in patients with cervicalofacial edema and paresthesia following transoral endoscopic thyroidectomy [ 38 ]. Several studies have compared postoperative pain levels between endoscopic and open thyroidectomy procedures, as well as different endoscopic approaches, using this pain scale [ 4 , 5 , 20 , 21 , 26 , 31 , 41 , 42 ].…”

Section: Assessment Of Sensory Alterationmentioning

confidence: 99%

“…Additionally, patients often weigh other factors such as surgical risks, long-term complications, overall effectiveness, postoperative discomfort, and the associated expenses [ 9 – 13 ]. Numerous studies have provided evidence supporting the equivalency of endoscopic thyroidectomy conducted through various approaches, to open thyroidectomy in terms of feasibility, safety, and validity [ 5 , 14 – 17 ]. Notably, endoscopic thyroidectomy demonstrates a clear advantage in terms of cosmetic outcomes when compared to conventional open thyroidectomy, although the methods of assessment may vary across different research articles.…”

Section: Introductionmentioning

confidence: 99%

Advances in the assessment of cosmetic outcomes, sensory alteration in surgical areas, and health-related quality of life of endoscopic thyroidectomy

Zhou,

Zhang,

Dou

et al. 2024

World J Surg Onc

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Background Endoscopic thyroidectomy has been preliminarily proven effective and safe for thyroid diseases. The cosmetic outcomes and life quality are critical contents of postoperative assessment. This review will primarily focus on the assessment methods and results related to cosmetic outcomes, sensory alteration of surgical area, and quality of life following endoscopic thyroidectomy. Methods A comprehensive search of published articles within the last decade was conducted using the terms “endoscopic/robotic thyroidectomy,” “patient satisfaction scores,” “questionnaire,” “quality of life,” and “cosmetic” in PubMed. Results Assessment methods for postoperative cosmetic satisfaction and sensory alterations encompassed verbal/visual analog scales, scar evaluations, Semmes–Weinstein monofilament tests, and more. The evaluation of postoperative quality of life in endoscopic thyroidectomy involved tools such as SF-36, SF-12, thyroid-specific questionnaires, thyroid cancer-specific quality of life questionnaires (THYCA-QOL), as well as assessments related to voice and swallow function. The cosmetic results of endoscopic thyroidectomy generally surpassed those of open thyroidectomy, while the quality of life in endoscopic procedures was either superior or equivalent to that in open thyroidectomy, especially with respect to general health, role emotion, and vitality. Conclusions Assessments of cosmetic outcomes and sensory alterations following endoscopic thyroidectomy predominantly relied on patients’ subjective feelings. The objective and subjective perspectives of scar assessments remain underutilized. In addition, postoperative laryngoscopy and voice function assessments in endoscopic thyroidectomy procedures require more attention.

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TOETVA: a single surgeon’s learning curve and a case report of CASTLE thyroid tumor

Jin,

Huang,

Guo

et al. 2023

Langenbecks Arch Surg

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Gasless endoscopic transaxillary thyroid surgery: CUSUM analysis of a single surgeon’s experience from 105 preliminary procedures

Cited by 10 publications

References 27 publications

Completion thyroidectomy and lateral neck dissection revealed adhesions in the lateral neck compartment after gasless transaxillary endoscopic thyroidectomy: a case report

Completion thyroidectomy and lateral neck dissection revealed adhesions in the lateral neck compartment after gasless transaxillary endoscopic thyroidectomy: a case report

Advances in the assessment of cosmetic outcomes, sensory alteration in surgical areas, and health-related quality of life of endoscopic thyroidectomy

TOETVA: a single surgeon’s learning curve and a case report of CASTLE thyroid tumor

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