Gasless Transaxillary Endoscopic Thyroidectomy: A Decade On

Sang-Wook Kang, MD, So Hee Lee, MD, Woong Youn Chung, MD, Ph, D, Kee-Hyun Nam, MD, Ph, D

Department of Surgery, Yonsei University College of Medicine

Background: In 2001, the authors developed a novel method of gasless transaxillary endoscopic thyroidectomy, and have now performed more than 1000 operations. This review was performed to document surgical outcomes after 10 years of experience with this technique, and to determine what the role of endoscopic thyroidectomy has in the current era.

Methods: All patients that underwent elective endoscopic thyroidectomy using the gasless transaxillary approach from November 2001 until December 2010 were evaluated. Patient demographics, surgical data, histological results, and complications were recorded and analyzed.

Results: 1085 patients underwent endoscopic thyroidectomy during the study period. Mean patient age was 36.9±9.7 years, the gender ratio was 1:49 (male:female), and there were 228 benign thyroid tumor cases and 857 thyroid malignancies. Trend analysis showed a progressive increase in case numbers per month until the end of 2007, followed by a steady decline. There were 175 total thyroidectomy cases and 910 cases of less-than-total thyroidectomy. Mean overall operating time was 132.92±48.6 minutes, and the overall complication rate was 13.5%. The most common complications were; transient hypocalcemia (6.3%), transient hoarseness (3.9%), hematoma (0.4%), permanent hypocalcemia (0.1%) and permanent recurrent laryngeal nerve injury (0.2%).

Conclusions: Gasless endoscopic thyroidectomy is a comparable to open thyroidectomy in tertms of early surgical outcomes and complications, and bridges the gap between conventional open surgery and robotic thyroidectomy.

Session: Poster Presentation

Program Number: P522

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