Endoscopic thyroidectomy through anterior chest and breast approach for papillary thyroid microcarcinoma

Objective To evaluate the operative feasibility and safety of endoscopic thyroidectomy through anterior chest and breast approach for the treatment of the patients with papillary thyroid microcarcinoma (PTMC). Methods Endoscopic thyroidectomy was attempted in 164 patients with thyroid diseases. For 28 cases, which were diagnosised as PTMC by frozen section intraopratively, lobotomy plus central compartment dissection and contralateral subtotal lobotomy was achieved completely by endoscopic thyroidectomy. There were 27 females and 1 male, and their average age was 35.2 years old. Twelve and sixteen cases were diagnosed preoperatively as thyroid microcarcinomas and benign tumors, respectively. Results The operation time of the 28 cases was (115±43) min.The maximum diameter of PTMC was0.2 to 1.0 cm with a mean of 0.56 cm. 17.9% (5/28) of the PTMC patients had transient vocal cord palsy and restored after 1 to 2 months postoperatively. There were no complications such as subcutaneous emphysema and postoperative bleeding and postoperative hypocalcaemia 46. 4% (13/28) had node involvement of the central compartment. Postoperative ultrasonography and scintigraphy showed no evidence of recurrence or residual thyroid tissue in the thyroid bed where lobotomy was performed. Conclusions The endoscopic thyroidectomy through anterior chest and breast approach is a choice of the surgical treatment for selected cases of PTMC. Key words: Thyroid neoplasms; Video-assisted surgery; Thyroidectomy