Objective: To evaluate the advantages and shortcomings of endoscopic thyroid surgery by trans-axilloareolar approach and trans-thoracoareolar approach.
Methods: Endoscopic thyroidectomy was performed in 238 cases from December 2003 to January 2006. The patients were randomly divided into two groups. One hundred and twenty-three patients received the trans-axilloareolar approach and 115 patients randomly received the trans-thoracoareolar approach procedure.
Results: All the operations were succeed. The operating duration of trans-axilloareolar approach group and trans-thoracoareolar approach group were (69 +/- 29) min and (70 +/- 25) min (P > 0.05), the blood lost were (38 +/- ll) ml and (40 +/- 13) ml (P > 0.05), the average hospitalized days were (4 +/- 1.3) d and (4.5 +/- 1.2) d (P > 0.05), the rate of satisfaction with the cosmetic effects of the procedures were 97.5% and 85.2% (P <0. 05). There were no conversions to open surgery or any complications. The drainage was removed at 24 h to 36 h after the operation.
Conclusions: Endoscopic thyroidectomy through trans-axilloareolar approach and trans-thoracoareolar approach is feasible, safe and cosmetic. The cosmetic effects of the trans-axilloareolar approach is better than the trans-thoracoareolar approach. The procedure selection depends on both the patient request and the technology of the surgeons.