New Endoscopic Thyroidectomy With the Transareola Single-site Approach: A Comparison With the Bilateral Areolar Approach

作者:Guo, Bo Min; Wu, Bo; Kang, Jie; Deng, Xian Zhao; Qin, Huan Long; Fan, You Ben*
来源:Surgical Laparoscopy Endoscopy & Percutaneous Techniques, 2015, 25(2): 178-184.
DOI:10.1097/SLE.0000000000000119

摘要

Purpose: We developed the transareola single-site approach (TASSA) for less invasive endoscopic thyroidectomy to avoid scars on exposed areas. Here, we report our experience with the TASSA technique in treatment of benign thyroid tumors and evaluate its feasibility through comparison with the bilateral areolar approach (BAA). Methods: From September 2009 to December 2011, 129 patients with benign thyroid tumors were enrolled in the study. Of these patients, 51 patients underwent endoscopic thyroidectomy by TASSA and 78 patients by BAA. The TASSA technique was performed using one 10mm trocar and one 5mm trocar through circumareolar incisions using conventional endoscopic instruments. The BAA procedure was performed using one 10mm trocar and two 5mm trocars through bilateral circumareolar incisions. Results: Comparing TASSA with BAA, there were significant differences in the mean operative time (141.96 /- 19.85 vs. 98.14 /- 14.15 min) for lobectomy (P < 0.05) and in the subcutaneous dissection area (101.00 /- 6.33 vs. 132.51 /- 5.25 cm(2), P < 0.05). However, there were no significant differences in the duration of hospitalization, amount of drainage, occurrence of postoperative complications, and postoperative pain. All the patients were satisfied with the cosmetic result in the 2 groups. Conclusions: Endoscopic thyroidectomy using the TASSA procedure is feasible and safe, and affords the advantages of minimal invasiveness and excellent cosmesis results compared with other approaches including BAA. The 2 procedures are technically more challenging procedures, which may become alternative procedures for treatment of patients with benign thyroid tumors, especially those with strong desire for cervical cosmesis.