RESUMEN
Conventional thyroidectomy often results in visible scarring postoperatively. Endoscopic thyroidectomy offers the advantage of scarless surgery, especially beneficial for young adult women. The retroauricular approach uses a facelift incision well-known among surgeons and eliminates the need for gas insufflation due to the large working space. An early retrospective analysis was conducted on thirty-one individuals who underwent gasless retroauricular endoscopic thyroidectomy approach, focusing on isthmolobectomies (n = 26) and lobectomies (n = 5), with one case necessitating conversion to open thyroidectomy, from January 2016 to April 2017. Physical examination, laboratory, and histopathology findings were collected. The scar was evaluated using the Vancouver Scale System, while other surgical and oncological outcomes were documented and assessed. The average operative time was 154.2 ± 21.3 min, with an average bleeding volume of 69.2 ± 52.1 mL. The average length of stay was 4.7 ± 2.2 days. All complications occurred were temporary and all subjects remained in good condition throughout the follow-up period. Most subjects (65.6%) were very satisfied with the scar concealed in the retroauricular area. Retroauricular endoscopic thyroidectomy is a safe and feasible remote access technique with excellent postoperative results.
RESUMEN
BACKGROUND: Most patients in Indonesia present with large-sized thyroid nodules, which need surgical removal to exclude malignancy. Many surgeons prefer endoscopic thyroidectomy to avoid a large and visible surgical scar on the neck and to reduce postoperative complications. This study aims to evaluate and analyze surgical feasibility, safety, oncologic outcome, and patient satisfaction of endoscopic thyroidectomy via the axillary-breast-shoulder approach. METHODS: Between August 2010 and September 2015, 42 endoscopic thyroidectomies via the axillary-breast-shoulder approach with carbon dioxide insufflation up to 8-10 mmHg were performed and retrospectively reviewed. RESULTS: Mean tumor size and operative time were 3.11 ± 0.99 cm and 189 ± 45 min, respectively. Mean blood loss was 68.3 mL. There were temporary complications such as hoarseness (19%), emphysema (2.3%) and hematoma (2.3%). Mean hospital length of stay was 3.98 days. Most subjects (61.9%) were very satisfied with the postoperative scar. The visual analog score of postoperative pain decreased from 4.83 on day-1 to 2.28 on day-7. The tumor recurrence was 9.6%. CONCLUSIONS: Endoscopic thyroidectomy via the axillary-breast-shoulder approach is feasible, safe, and minimally invasive with excellent postoperative results.