A comparative study on the clinical efficacy and safety of conventional open thyroidectomy and bilateral areolar approach thyroidectomy.

OBJECTIVE

To compare the clinical outcomes and safety profiles of conventional open thyroidectomy and bilateral areolar approach thyroidectomy.

METHODS

A total of 72 patients who underwent endoscopic thyroidectomy at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine between August 2021 and March 2024 were retrospectively included as the endoscopic group (EG). Sixty-five patients who underwent conventional open thyroidectomy during the same period served as the control group (CG). Baseline characteristics, intraoperative parameters, postoperative outcomes, pain levels, incidence of postoperative complications, and three-month Numerical Scoring System (NSS) aesthetic scores were compared between the two groups.

RESULTS

Compared to the CG, the EG had a longer operative time but experienced less intraoperative blood loss and a shorter hospital stay (both P < 0.05). Postoperative white blood cell counts and C-reactive protein levels were significantly lower in the EG (both P < 0.05). Visual Analogue Scale scores on postoperative days 1, 2, and 3 were also significantly lower in the EG (all P < 0.05). The incidence of complications was lower in the EG than in the CG (P < 0.05). At the three-month follow-up, the EG demonstrated significantly higher NSS aesthetic scores compared to the CG (P < 0.05). Multivariable analysis identified age ≥ 50 years, open surgery, operative time ≥ 130 minutes, and intraoperative blood loss ≥ 60 mL as independent risk factors for postoperative complications (all P < 0.05).

CONCLUSION

Bilateral areolar approach thyroidectomy offers advantages over conventional open thyroidectomy, including reduced tissue trauma, faster postoperative recovery, lower pain levels, a reduced incidence of complications, and superior short-term aesthetic satisfaction.