Endoscopic vs. conventional thyroidectomy for the treatment of benign thyroid tumors: A retrospective study of a 4-year experience.

Endoscopic thyroidectomy (ET) allows surgeons to remove a thyroid tumor from a remote site, while providing excellent results from a cosmetic viewpoint. The aim of this study was to explore the appropriateness and outcomes of ET via breast approach for the treatment of benign thyroid tumors. A total of 637 patients with benign thyroid tumors were recruited in our department. Two hundred and eighty-five patients underwent the ET via breast approach (ET group) and 352 matched control patients underwent conventional thyroidectomy (ConT group). Variables, such as surgery-related outcomes and postoperative complications, were compared between these two groups. A unilateral lobectomy was performed in 126 patients (44.2%) of the ET group and in 163 patients (46.3%) of the ConT group. A bilateral total thyroidectomy was performed in 159 patients (55.8%) of the ET group and in 189 patients (53.7%) of the ConT group. The operative time in the ET group was longer compared to the ConT group (79.9±20.10 vs. 45.4±11.90 min, P<0.001, for unilateral lobectomy; and 89.9±14.60 vs. 60.0±8.44 min, P<0.001, for bilateral total thyroidectomy). The ET group had a significantly longer mean hospital stay compared to the ConT group (5.5±0.50 vs. 5.3±0.75 days, P=0.002). There was no case of conversion to conventional open surgery in the ET group. The recurrent laryngeal nerves and parathyroid glands were identified and protected in all cases. Our results indicate that ET performed via breast is a technically feasible and safe procedure with excellent cosmetic results for patients with benign thyroid tumors.