Clinical application of endoscopic thyroidectomy by anterior chest approach

Objective: To explore the value of endoscopic thyroidectomy by anterior chest approach in the treatment of thyroid diseases.Methods:Retrospectively analysed the clinical data of 58 patients with benign thyroid diseases undergone endoscopic thyroidectomy,in which the observation port was made about 10cm beneath the sternal notch and the operation ports about 5cm above the nipples on midclavicular line.Results:Except that 4 patients were converted to traditional operations,54 patients received complete endoscopic procedure,including endoscopic adenoma resection(38 cases),unilateral subtotal thyroidectomy(14 cases),and bilateral subtotal thyroidectomy(2 cases).The mean operative time was 134min(range,115-230min);mean blood loss was 26ml(range,5-80ml);and mean postoperative hospitalization was 4.6d(range,3-7d).1 case was complicated with subcutaneous emphysema,4 cases with subcutaneous ecchymosis,and 2 cases with paraesthesia of anterior neck region,but all disappeared in less than 1 month.All the patients were satisfied with the cosmetic effect.With a follow-up of 8-38 months,only 2 patients with nodular goiter recurrented who are still under observation,and the thyroid function of the patients with hyperthyroidism are normal.Conclusions:Endoscopic thyroidectomy by anterior chest approach not only has satisfied cosmetic effect,but also reduces the operative trauma.Combined with the advantages of economic,safe and effective,it is worth being promoted clinically.