A modified, single-incision, gasless, endoscopic thyroidectomy and bilateral central neck dissection via axillary approach technique for bilateral papillary thyroid microcarcinoma: A preliminary report

Shi-Tong Yu; Jun-Na Ge; Bai-Hui Sun; Zhi-Gang Wei; Zhi-Cheng Zhang; Wei-Sheng Chen; Ting-Ting Li; Shang-Tong Lei

doi:10.1016/j.heliyon.2024.e24802

A modified, single-incision, gasless, endoscopic thyroidectomy and bilateral central neck dissection via axillary approach technique for bilateral papillary thyroid microcarcinoma: A preliminary report

Heliyon. 2024 Jan 23;10(3):e24802. doi: 10.1016/j.heliyon.2024.e24802. eCollection 2024 Feb 15.

Authors

Shi-Tong Yu¹, Jun-Na Ge¹, Bai-Hui Sun¹, Zhi-Gang Wei¹, Zhi-Cheng Zhang¹, Wei-Sheng Chen¹, Ting-Ting Li¹, Shang-Tong Lei¹

Affiliation

¹ Department of General Surgery, Nanfang Hospital, The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China.

Abstract

Background: Our objective was to assess the viability and oncological security of a gasless, transaxillary single-incision endoscopic procedure for performing total thyroidectomy and bilateral central neck dissection (TT + BCND). This study focused on patients diagnosed with bilateral papillary thyroid microcarcinoma (PTMC).

Method: Between April 2020 and November 2021, 22 patients with bilateral PTMC underwent single-incision, gasless, transaxillary endoscopic TT + BCND. The patients' clinicopathologic characteristics, surgical completeness and complications were analyzed.

Result: Single-incision, gasless, transaxillary endoscopic TT + BCND was successful performed in all patients. The median (IQR) total surgical time was 143 (85-160) min. Only two patients experienced transient unilateral RLN palsy or transient hypocalcemia. All these complications resolved within 1 month after surgery. The median duration of hospital stay after surgery was 4 (3-4.5) days. The median hospitalization expense for these patients was 3848 (3781-4145) USD. The median number of lymph node yielded was 10.5 (8-15). The cosmetic outcomes were well-received by all individuals.

Conclusion: In certain cases, gasless, transaxillary endoscopic TT + BCND procedure performed through a single incision proved to be a secure alternative for managing bilateral PTMC.

Keywords: Endoscopic thyroidectomy; Thyroid cancer; Transaxillary endoscopic surgery.