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Endoscopic thyroidectomy by the axillary approach Yoshifumi IKEDA 1 , Junichi TAKAYAMA 1 , Hiroshi TAKAMI 1 1Department of Surgery, Teikyo University School of Medicine Keyword: 内視鏡下手術 , 甲状腺手術 , 腋窩アプローチ法 pp.265-269
Published Date 2008/6/15
DOI https://doi.org/10.11477/mf.4426100189
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 Minimally invasive surgery is widely employed for the treatment of thyroid diseases. We have performed pure endoscopic thyroidectomy by the axillary approach from 1999. In this study, we evaluate the efficacy of this surgical procedure. The indications for this procedure included the presence of a benign thyroid nodule with a maximum diameter of less than 6 cm as observed during a preoperative ultrasonography examination, Graves' disease and small low-risk papillary thyroid carcinomas. Our procedure is pure endoscopic thyroidectomy with carbon dioxide insufflation from an axillary portion. This procedure was performed in 122 patients, 7 of whom had papillary thyroid carcinomas. Conversion was necessary in 3 patients. Thyroid partial recection was successfully accomplished in 21 patients, thyroid lobectomy in 93 patients and subtotal thyroidectomy for 5 patients with Graves' disease. Unilateral central neck lymph node dissection was completed in 7 patients without any complications. Major vessel bleeding during surgery was experienced in 2 patients, however, these complications were controlled by endoscopic procedure. The mean operative time for thyroid lobectomy was 155 minutes. Postoperative complications included 3 transient recurrent nerve palsies, and 1 postoperative arm pain. The cosmetic result was excellent and almost all patients were satisfied with the results. Indications for pure endoscopic thyroidectomy are still limited. Nonetheless, in selected patients including low risk small papillary carcinoma, it seems a valid option for thyroidectomy and even preferable to conventional surgery because of its significant advantages, especially in terms of cosmetic result.


Copyright © 2008, JAPAN SOCIETY FOR ENDOSCOPIC SURGERY All rights reserved.

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電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会

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