Experiences of 420 Patients Underwent Total Endoscopic Thyroidectomy Via ChestBreast Approach_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHOUMing ,  LIUWei-wei , GUYi-fan , SHENJi-ying , SUNPeng

Department of General Surgery, Shanghai Tongren Hospital, Shanghai 200336, China;

Corresponding author：

LIUWei-wei, Email: 13651740411@126.com

Keywords：

Total endoscopic thyroidectomy; Safety; Aesthetic effect

DOI：

10.7507/1007-9424.20160153

Video：

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Objective To discuss clinical significance of total endoscopic thyroidectomy (TET) via chest-breast approach. Methods The clinical data of 890 patients with thyroid diseases from September 2008 to September 2015 in this hospital were analyzed retrospectively. These patients were divided into TET group (received TET, n=420) and traditional group (received traditional thyroidectomy, n=470). The data of operation and postoperative recovery were compared between these two groups. Results There was no significant difference between the TET group and the traditional group in the operation time [(73.571 4±28.533 9) min versus (70.212 8±27.199 8) min, t=1.80, P=0.072 7], bleeding volume [(30.714 3±14.225 1) mL versus (29.106 4±13.559 1) mL, t=1.73, P=0.084 8], postoperative drainage [(60.000 0±27.287 9) mL versus (56.595 7±27.803 5) mL, t=1.84, P=0.066 2], postoperative hospitalization time [(5.333 3±1.085 1) d versus (5.446 8± 1.089 0) d, t=1.55, P=0.120 4], postoperative 24 h pain score [(5.333 3±2.308 7) points versus (5.404 3±2.182 1) points, t=0.47, P=0.637 8] and postoperative injury rate of recurrent laryngeal nerve [0.714 2% (3/420) versus 0.851 1% (4/470), x²=0.053 2, P=0.817 6] and hypoparathyroidism rate [0.476 2% (2/420) versus 0.851 1% (4/470), x²=0.465 5, P=0.495 1]. The score of aesthetic effect of incision on day 7 after operation in the TET group was significantly higher than that in the traditional group [(7.809 5±1.296 9) points versus (3.361 7±1.391 8) points, t=49.14, P < 0.000 1]. Conclusion TET is safe and effective, and could improve cosmetic effect for patients with thyroid diseases.

Citation： ZHOUMing, LIUWei-wei, GUYi-fan, SHENJi-ying, SUNPeng. Experiences of 420 Patients Underwent Total Endoscopic Thyroidectomy Via ChestBreast Approach. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(5): 569-572. doi: 10.7507/1007-9424.20160153 Copy

1.	王存川, 苏超.内镜甲状腺切除术的现状及前景.临床外科杂志, 2005, 13(10):605-606.
2.	Hüscher CS, Choidini S, Napolitano C, et al. Endoscopic right thyroid lobectomy, Surg Endosc, 1997, 11(8):877.
3.	仇明, 丁尔迅, 江道振, 等.颈部无瘢痕内镜甲状腺切除1例.中华普通外科杂志, 2002, 17(2):127.
4.	关强, 王贵民, 王宏升.胸骨前径路与改良Miccoli腔镜甲状腺手术临床研究.中国普外基础与临床杂志, 2010, 17(3):240-242.
5.	Zhang W, Jiang DZ, Liu S, et al. Current status of endoscopic thyroid surgery in China. Surg Laparosc Endosc Percutan Tech, 2011, 21(2): 67-71.
6.	Jin X, Lu B, Cai X, et al. Total endoscopic thyroidectomy via bilateral breast and ipsilateral axillary approach:a clinical feasibility study. J Craniofac Surg, 2014, 25(3):738-741.
7.	Cho MJ, Park KS, Cho MJ, et al. A comparative analysis of endoscopic thyroidectomy versus conventional thyroidectomy in clinically lymph node negative thyroid cancer. Ann Surg Treat Res, 2015, 88(2):69-76.
8.	苏磊, 桑剑锋, 姚永忠, 等.经胸乳入路腔镜甲状腺切除的手术技巧.中国普外基础与临床杂志, 2013, 20(5):512-516.
9.	Park KN, Cho SH, Lee SW. Nationwide multicenter survey for current status of endoscopic thyroidectomy in Korea. Clin Exp Otorhinolaryngol, 2015, 8(2):149-154.
10.	Tori M. Hybrid-type endoscopic thyroidectomy (HET:Tori's method) for differentiated thyroid carcinoma including invasion to the trachea. Surg Endosc, 2014, 28(3):902-909.
11.	Zhou J, Wu Z, Wang Y, et al. Endoscopic thyroidectomy for bilateral thyroid diseases:safety and effectiveness. J Craniofac Surg, 2012, 23(2):565-570.
12.	Wang C, Feng Z, Li J, et al. Endoscopic thyroidectomy via areola approach:summary of 1250 cases in a single institution. Surg Endosc, 2015, 29(1):192-201.
13.	Guimaraes AV, Brandao LG, Dedivitis RA. Contact endoscopy for identifying the parathyroid glands during thyroidectomy. Acta Otolaryngol, 2010, 30(1):20-26.
14.	Yan H, Wang Y, Wang P, et al". Scarless" (in the neck) endoscopic thyroidectomy (SET) with ipsilateral levelsⅡ, ⅢandⅣdissection via breast approach for papillary thyroid carcinoma:a preliminary report. Surg Endosc, 2015, 29(8):2158-2163.
15.	Wang YC, Zhu JQ, Liu K, et al. Surgical outcomes comparison between endoscopic and conventional open thyroidectomy for benign thyroid nodules. J Craniofac Surg, 2015, 26(8):e714-e718.
16.	Yang J, Wang C, Li J, et al. Complete endoscopic thyroidectomy via oral vestibular approach versus areola approach for treatment of thyroid diseases. J Laparoendosc Adv Surg Tech A, 2015, 25(6):470-476.
17.	Liao HJ, Dong C, Kong FJ, et al. The CUSUM analysis of the learning curve for endoscopic thyroidectomy by the breast approach. Surg Innov, 2014, 21(2):221-228.
18.	Jiang ZG, Zhang W, Jiang DZ, et al. Clinical benefits of scarless endoscopic thyroidectomy:An expert's experience. World J Surg, 2011, 35(3):553-557.
19.	Chen B, Wang Y, Xuan S, et al. Endoscopic thyroidectomy:The development in a Chinese center. J Laparoendosc Adv Surg Tech A, 2012, 22(1):76-80.
20.	Li Z, Wang P, Wang Y, et al. Endoscopic lateral neck dissection via breast approach for papillary thyroid carcinoma:a preliminary report. Surg Endosc, 2011, 25(3):890-896.
21.	Zhang W, Dang C, Shan C, et al. Use of a mini-instrument in endoscopic thyroidectomy via a breast approach to improve cosmetic outcomes. Biosci Trends, 2014, 8(5):280-285.
22.	Liu S, Zheng XM, Jiang DZ, et al. New technique for retraction of the strap muscles in endoscopic thyroidectomy. Surg Innov, 2011, 18(2):141-144.
23.	樊友本, 钟春林, 伍波, 等.单孔腔镜甲状腺手术.腹腔镜外科杂志, 2012, 17(1):7-9.
24.	Lee D, Nam Y, Sung K. Single-incision endoscopic thyroidectomy by the axillary approach. Laparoendosc Adv Surg Tech A, 2010, 20(10):839-842.
25.	Fan YB, Wu B, Zhong CL, et al. Trans-areola single-site endoscopic thyroidectomy:Pilot study of 35 cases. Surg Endosc, 2012, 26(4): 939-947.
26.	Kandil EH, Noureldine SI, Yao L, et al. Robotic transaxillary thyroidectomy:an examination of the first one hundred cases. J Am Coll Surg, 2012, 214(4):558-564.
27.	Wang C, Zhai H, Liu W, et al. Thyroidectomy:a novel endoscopic oral vestibular approach. Surgery, 2014, 155(1):33-38.
28.	Choi JY, Lee KE, Chung KW, et al. Endoscopic thyroidectomy via bilateral axillo-breast approach (BABA):Review of 512 cases in a single institute. Surg Endosc, 2012, 26(4):948-955.

1. 王存川, 苏超.内镜甲状腺切除术的现状及前景.临床外科杂志, 2005, 13(10):605-606.
2. Hüscher CS, Choidini S, Napolitano C, et al. Endoscopic right thyroid lobectomy, Surg Endosc, 1997, 11(8):877.
3. 仇明, 丁尔迅, 江道振, 等.颈部无瘢痕内镜甲状腺切除1例.中华普通外科杂志, 2002, 17(2):127.
4. 关强, 王贵民, 王宏升.胸骨前径路与改良Miccoli腔镜甲状腺手术临床研究.中国普外基础与临床杂志, 2010, 17(3):240-242.
5. Zhang W, Jiang DZ, Liu S, et al. Current status of endoscopic thyroid surgery in China. Surg Laparosc Endosc Percutan Tech, 2011, 21(2): 67-71.
6. Jin X, Lu B, Cai X, et al. Total endoscopic thyroidectomy via bilateral breast and ipsilateral axillary approach:a clinical feasibility study. J Craniofac Surg, 2014, 25(3):738-741.
7. Cho MJ, Park KS, Cho MJ, et al. A comparative analysis of endoscopic thyroidectomy versus conventional thyroidectomy in clinically lymph node negative thyroid cancer. Ann Surg Treat Res, 2015, 88(2):69-76.
8. 苏磊, 桑剑锋, 姚永忠, 等.经胸乳入路腔镜甲状腺切除的手术技巧.中国普外基础与临床杂志, 2013, 20(5):512-516.
9. Park KN, Cho SH, Lee SW. Nationwide multicenter survey for current status of endoscopic thyroidectomy in Korea. Clin Exp Otorhinolaryngol, 2015, 8(2):149-154.
10. Tori M. Hybrid-type endoscopic thyroidectomy (HET:Tori's method) for differentiated thyroid carcinoma including invasion to the trachea. Surg Endosc, 2014, 28(3):902-909.
11. Zhou J, Wu Z, Wang Y, et al. Endoscopic thyroidectomy for bilateral thyroid diseases:safety and effectiveness. J Craniofac Surg, 2012, 23(2):565-570.
12. Wang C, Feng Z, Li J, et al. Endoscopic thyroidectomy via areola approach:summary of 1250 cases in a single institution. Surg Endosc, 2015, 29(1):192-201.
13. Guimaraes AV, Brandao LG, Dedivitis RA. Contact endoscopy for identifying the parathyroid glands during thyroidectomy. Acta Otolaryngol, 2010, 30(1):20-26.
14. Yan H, Wang Y, Wang P, et al". Scarless" (in the neck) endoscopic thyroidectomy (SET) with ipsilateral levelsⅡ, ⅢandⅣdissection via breast approach for papillary thyroid carcinoma:a preliminary report. Surg Endosc, 2015, 29(8):2158-2163.
15. Wang YC, Zhu JQ, Liu K, et al. Surgical outcomes comparison between endoscopic and conventional open thyroidectomy for benign thyroid nodules. J Craniofac Surg, 2015, 26(8):e714-e718.
16. Yang J, Wang C, Li J, et al. Complete endoscopic thyroidectomy via oral vestibular approach versus areola approach for treatment of thyroid diseases. J Laparoendosc Adv Surg Tech A, 2015, 25(6):470-476.
17. Liao HJ, Dong C, Kong FJ, et al. The CUSUM analysis of the learning curve for endoscopic thyroidectomy by the breast approach. Surg Innov, 2014, 21(2):221-228.
18. Jiang ZG, Zhang W, Jiang DZ, et al. Clinical benefits of scarless endoscopic thyroidectomy:An expert's experience. World J Surg, 2011, 35(3):553-557.
19. Chen B, Wang Y, Xuan S, et al. Endoscopic thyroidectomy:The development in a Chinese center. J Laparoendosc Adv Surg Tech A, 2012, 22(1):76-80.
20. Li Z, Wang P, Wang Y, et al. Endoscopic lateral neck dissection via breast approach for papillary thyroid carcinoma:a preliminary report. Surg Endosc, 2011, 25(3):890-896.
21. Zhang W, Dang C, Shan C, et al. Use of a mini-instrument in endoscopic thyroidectomy via a breast approach to improve cosmetic outcomes. Biosci Trends, 2014, 8(5):280-285.
22. Liu S, Zheng XM, Jiang DZ, et al. New technique for retraction of the strap muscles in endoscopic thyroidectomy. Surg Innov, 2011, 18(2):141-144.
23. 樊友本, 钟春林, 伍波, 等.单孔腔镜甲状腺手术.腹腔镜外科杂志, 2012, 17(1):7-9.
24. Lee D, Nam Y, Sung K. Single-incision endoscopic thyroidectomy by the axillary approach. Laparoendosc Adv Surg Tech A, 2010, 20(10):839-842.
25. Fan YB, Wu B, Zhong CL, et al. Trans-areola single-site endoscopic thyroidectomy:Pilot study of 35 cases. Surg Endosc, 2012, 26(4): 939-947.
26. Kandil EH, Noureldine SI, Yao L, et al. Robotic transaxillary thyroidectomy:an examination of the first one hundred cases. J Am Coll Surg, 2012, 214(4):558-564.
27. Wang C, Zhai H, Liu W, et al. Thyroidectomy:a novel endoscopic oral vestibular approach. Surgery, 2014, 155(1):33-38.
28. Choi JY, Lee KE, Chung KW, et al. Endoscopic thyroidectomy via bilateral axillo-breast approach (BABA):Review of 512 cases in a single institute. Surg Endosc, 2012, 26(4):948-955.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Experiences of 420 Patients Underwent Total Endoscopic Thyroidectomy Via ChestBreast Approach

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