Outcomes of endoscopic hemithyroidectomy via axillary–breast– shoulder approach in benign thyroid nodules

Abstract

Background: Endoscopic thyroidectomy via the axillary, anterior, and breast approaches has been introduced in many individual surgical institutions around the world. The unilateral axillo-breast approach is a surgical resection of the thyroid lobe remotely from the neck without a neck scar shifting the scar to an area that is covered by clothing. Endoscopic thyroidectomy requires meticulous surgical dissection, absolute hemostasis, en bloc tumor resection, and adequate visualization of the operative field. Aim: To assess the feasibility and safety of endoscopic hemithyroidectomy via the axillary–breast–shoulder (ABS) approach in the management of solitary thyroid nodules and subsequent complications of this procedure. Patients and Methods: In all, 25 individuals with benign solitary thyroid nodules smaller than 5 cm in one lobe were included in our study. All patients have opted for endoscopic thyroid surgery. Using fine-needle aspiration cytology, the patients included met the benign criteria (FNAC). Within 48 h, we used a visual analog scale to assess postoperative discomfort. Assessment of the patient’s satisfaction with the cosmetic outcomes was made 1, 3, and 6 months following surgery. Results: The majority of studied cases (23 cases) had no intraoperative complications, while two cases had either ecchymosis or emphysema. There was a statistically significant difference as regards cosmetic results change during follow-up between 1 month and 3 months, between 1 month and 6 months, and between 3 and 6 months. There was a statistically significant difference as regards VAS change during follow-up between 12 and 24 h, between 12 and 48 h, and between 24 and 48 h. Conclusion: This study provided evidence that, in certain individuals with benign thyroid disease, endoscopic thyroidectomy via ABS route is a safe, successful treatment that yields great esthetic outcomes. The ABS technique is a viable, safe, and aesthetically pleasing substitute for a traditional open thyroidectomy.