Scarless neck thyroidectomy using bilateral axillo-breast approach: Initial impressions after introduction in a specialized unit and a review of the literature

Translated title of the contribution: Scarless neck thyroidectomy using bilateral axillo-breast approach: Initial impressions after introduction in a specialized unit and a review of the literature

Enrique Mercader Cidoncha, Iñaki Amunategui Prats, José Luis Escat Cortés, Irene Grao Torrente, Hyunsuk Suh

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Introduction: The extracervical approach for thyroidectomy remains widely unknown in our country. Its main aim is to avoid a cervical scar while maintaining the same safety profile of conventional thyroidectomy. The objective is to communicate our experience after the first 15 cases using the endoscopic bilateral axillo-breast approach (BABA) and to review critical points described in literature. Methods: Between June 2017 and June 2018, 15 endoscopic thyroidectomies were performed using the BABA extracervical approach, locating incisions in axillary folds and areolar borders. Indications were benign goiter and suspicious nodule (Bethesda 3 and 4). Results: All 15 cases (12 patients) were treated using the extracervical endoscopic technique. We performed 5 total thyroidectomies, 7 hemithyroidectomies and 3 completion thyroidectomies. Mean surgical time for total thyroidectomy was 285 minutes and 210 minutes for hemithyroidectomy. The average hospital stay was 1.67 days. With a mean follow-up of 7.73 months, rates of transient and definitive hypoparathyroidism were 37% and 0%, and transient recurrent nerve palsy occurred in one case. Anterior chest paraesthesia rate was 80%, which were mild and resolved within the first month. The degree of cosmetic satisfaction is very high. Conclusion: Our experience with endoscopic bilateral axillo-breast approach thyroidectomy is short but satisfactory. It is a reproducible procedure that requires extensive experience in endocrine and endoscopic surgery. Extracervical approaches are an alternative for selected patients who are especially concerned about cervical scarring and are not intended to displace conventional thyroidectomy, which is the current gold standard. Our Scientific Society should explore these approaches to establish coherent indications and limitations.

Translated title of the contributionScarless neck thyroidectomy using bilateral axillo-breast approach: Initial impressions after introduction in a specialized unit and a review of the literature
Original languageEnglish
Pages (from-to)81-88
Number of pages8
JournalCirugia Espanola
Volume97
Issue number2
DOIs
StatePublished - Feb 2019

Keywords

  • BABA endoscopic thyroidectomy
  • Bilateral axillo-breast approach
  • Endoscopic thyroidectomy
  • Scarless thyroidectomy

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