Comparative study of gasless endoscopic selective lateral neck dissection via the anterior chest approach versus conventional open surgery for papillary thyroid carcinoma

Surg Endosc. 2021 Feb;35(2):693-701. doi: 10.1007/s00464-020-07434-6. Epub 2020 Feb 19.

Abstract

Background: Although there has been increasing interest in aesthetical approaches for treating patients with papillary thyroid carcinoma (PTC), there have been no studies comparing the safety and effectiveness of gasless endoscopic selective lateral neck dissection (SLND) via the anterior chest approach (ACA) with that of conventional open surgery (OPEN) for papillary thyroid carcinoma.

Methods: A total of 91 patients with PTC who underwent either gasless endoscopic thyroidectomy, central compartment neck dissection and SLND via the ACA or conventional open surgery between Nov. 2008 to Dec. 2018 were included. Primary outcomes and demographic data were compared between the two groups.

Results: Thirty-one patients were in the ACA group and 60 were in the OPEN group. The ACA group was younger and had a longer operative time but less intraoperative hemorrhage (P < 0.001 for all). There were no differences in other clinicopathological features. During the median follow-up of 48 months (ACA group) and 35 months (OPEN group), no recurrence on US/CT was found. The patients in the ACA group had better cosmetic results assessed postoperatively.

Conclusion: It appeared that gasless endoscopic selective lateral neck dissection via the anterior chest approach achieved comparable safety and effectiveness as conventional open surgery for PTC and resulted in better cosmetic results.

Keywords: Anterior chest approach; Cosmetic; Endoscopic thyroidectomy; Neck dissection; Papillary thyroid carcinoma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Endoscopy / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neck Dissection / methods*
  • Thyroid Cancer, Papillary / surgery*
  • Young Adult