Modified version of minimally invasive open thyroidectomy using an unilateral incision

Kim, Soo Young; Kim, Hee Jun; Chang, Hojin; Kim, Seok Mo; Lee, Yong Sang; Chang, Heon-Young; Park, Cheong Soo

doi:10.1016/j.asjsur.2021.02.024

Cited by 3 publications

(5 citation statements)

References 17 publications

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“…Two cases of drain insertion were included (0.8%) with Park’s team, while we did not have any cases. 28 In addition, the postoperative hospitalization period was 2.8±0.4 days, which was significantly shorter than that of COT reported by us and Park’s team ( p <0.001). 19 28 …”

Section: Discussionmentioning

confidence: 54%

“… 28 In addition, the postoperative hospitalization period was 2.8±0.4 days, which was significantly shorter than that of COT reported by us and Park’s team ( p <0.001). 19 28 …”

Section: Discussionmentioning

confidence: 54%

“…In a recently published paper, Park’s team reported the results of less than total and total thyroidectomy using a unilateral lower neck small incision, similar to ours. 28 While this modified MIT method approached between the strap muscles to expose the thyroid, we exposed the thyroid without damaging the strap muscle’s natural anatomy. To do so, our newly developed surgical instruments, Nam’s long Senn retractor and Nam’s right-angle retractor, were used.…”

Section: Discussionmentioning

confidence: 99%

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Minimally Invasive Open Bilateral Total Thyroidectomy Using Unilateral Neck Incision in Thyroid Cancer: Preliminary Surgical and Quality of Life Outcomes

Lee,

Kim,

Kim

et al. 2024

Yonsei Med J

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Purpose Thyroid cancer incidence has increased in recent decades, and thyroid surgery is continuously evolving in response to demands for postoperative comfort and cosmesis. This study aimed to introduce a new surgical method for minimally invasive open bilateral total thyroidectomy (MI-BTT) using a unilateral 2.5–3.0 cm neck incision. Furthermore, we reported the surgical outcomes and postoperative quality of life (QoL) using a validated Korean translated Dermatology Life Quality Index (DLQI) questionnaire. Materials and Methods We retrospectively evaluated 41 Asian patients who underwent MI-BTT for low-risk papillary thyroid cancer by a single surgeon from March 2019 to December 2021. Results A total of 4 male and 37 female patients were included. The mean age and body mass index were 46.2±10.1 years and 23.3±3.3 kg/m 2 , respectively. The average tumor size was 1.1±0.6 cm, and 36 patients (87.8%) had bilateral cancer. Twenty-three (56.1%) patients had occult central lymph node (CLN) metastasis in the final pathologic report, with the mean number of dissected CLNs being 7.2±6.5. Gross capsular extension was found in 6 patients (14.6%). Moreover, 28 patients (68.3%) received additional treatment after surgery with low or high doses of radioactive iodine. The average serum-stimulated thyroglobulin value identified during treatment was 1.57±2.30 ng/mL. The mean operation time was 78.0±13.9 minutes, and postoperative complications included transient hypocalcemia (36.6%), transient hoarseness (24.4%), and seroma (2.4%). The mean total DLQI score was 2.73±0.78, indicating a small effect on QoL. Conclusion MI-BTT is a novel, safe, and feasible technique to improve patient satisfaction for surgical scars and QoL.

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Section: Discussionmentioning

confidence: 54%

“… 28 In addition, the postoperative hospitalization period was 2.8±0.4 days, which was significantly shorter than that of COT reported by us and Park’s team ( p <0.001). 19 28 …”

Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

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Minimally Invasive Open Bilateral Total Thyroidectomy Using Unilateral Neck Incision in Thyroid Cancer: Preliminary Surgical and Quality of Life Outcomes

Lee,

Kim,

Kim

et al. 2024

Yonsei Med J

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“…Traumatic surgery is easy to cause damage to the surrounding tissues, especially the recurrent laryngeal nerve has no fixed connection with thyroid artery, so it is difficult to determine the specific location of the recurrent laryngeal nerve during the surgical operation. In addition, the distribution of the inferior polar vein vessels in the body is complex and fragile, and bleeding symptoms may occur during the separation process, which will induce various complications ( 21 , 22 ). Serum PTH is an important index reflecting parathyroid function, while TSH and FT3 are indicators reflecting thyroid function ( 23 , 24 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Modified Small Incision Thyroidectomy and Analysis of Influencing Factors of Postoperative Hypocalcemia

Zhou¹,

Ju²,

Ma³

et al. 2022

Front. Surg.

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ObjectiveAnalyze the clinical effect of modified small incision thyroidectomy and evaluate the influencing factors of hypocalcemia (EH) in patients after operation.MethodsA total of 220 patients with thyroid cancer in our hospital from October 2019 to October 2021 were selected. The patients were randomly divided into a control group and an observation group, with 110 patients in each group. The control group were treated with traditional thyroidectomy, while the observation group were treated with modified small incision surgery. The perioperative indicators of the two groups were compared. The thyroid hormone indexes of the two groups were meansured before operation and 7 days after operation, and the incidence of complications was compared between the two groups. Serum calcium was detected 7 days after operation in both groups. According to the level of blood calcium, patients were divided into EH group and normal group. The data of two groups were compared, and the related factors affecting the occurrence of EH after operation were analyzed.ResultsThe operation time, incision length and intraoperative bleeding volume of patients in the observation group were significantly lower than those of patients in the control group (p < 0.05). There was no significant difference in drainage time and postoperative drainage volume between the two groups (p > 0.05). The postoperative PTH level of patients in the observation group was significantly higher than that in the control group (p < 0.05), but there was no significant difference in FT3, FT4 and TSH levels (p > 0.05). The incidence of postoperative complications in the observation group (11.82%) was significantly lower than that in the control group (34.55%). Logistic regression analysis showed that bilateral lymph node dissection, parathyroidectomy and decreased PTH were the independent risk factors for EH in our patient after operation (p < 0.05).ConclusionThe modified small incision operation can effectively reduce the occurrence of surgical trauma and related complications. Bilateral lymph node dissection, parathyroidectomy and PTH decrease are the risk factors for postoperative EH in patients with thyroid cancer. Taking corresponding measures to improve the metabolic function of patients during perioperative period will help to reduce the incidence of postoperative EH in patients with thyroid cancer.

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“…Kim et al. ( 7 ) developed a new surgical approach, making a unilateral incision of 2.5–3.5 cm without crossing the midline along the skin crease in the lower neck ( Figure 1C ). In case of unilateral disease, the incision was made at the same side laterally, whereas for bilateral disease, in which case bilateral total thyroidectomy was performed, the incision was made on the side of the main lesion.…”

Section: Cervical Approachmentioning

confidence: 99%

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

et al. 2023

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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.

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Modified version of minimally invasive open thyroidectomy using an unilateral incision

Cited by 3 publications

References 17 publications

Minimally Invasive Open Bilateral Total Thyroidectomy Using Unilateral Neck Incision in Thyroid Cancer: Preliminary Surgical and Quality of Life Outcomes

Minimally Invasive Open Bilateral Total Thyroidectomy Using Unilateral Neck Incision in Thyroid Cancer: Preliminary Surgical and Quality of Life Outcomes

Clinical Efficacy of Modified Small Incision Thyroidectomy and Analysis of Influencing Factors of Postoperative Hypocalcemia

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

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