액와접근법을 이용한 무기하 내시경적 갑상선절제술 30예

Gasless Endoscopic Thyroidectomy Via an Axillary Approach: Experience of 30 Cases

Purpose: Surgery for thyroid disease requires a skin incision that can result in postsurgical problems such as prominent scars, adhesions, hypesthesia, and paresthesia in the neck. To overcome these problems, we performed a gasless endoscopic thyroidectomy via an axillary approach. Methods: Between May 2004 and April 2005, 30 female patients underwent gasless endoscopic thyroidectomy via an axillary approach. Surgical outcomes were evaluated in terms of operating time, length of hospital stay, and the incidence of perioperative complications. Patient opinion was assessed using a verbal response scale at two and four months after surgery. Results: The mean operating time was 126.8⁑32.4 minutes, and the mean length of hospital stay was 4.3⁑1.1 days. No cases required conversion to open surgery and none involved significant intraoperative complications. Three patients (10.0%) complained slight hypesthesia or paresthesia in the anterior chest wall, and only 2 patients (6.7%) complained the discomfort while they were swallowing for 4 months after surgery. All patients were satisfied with the cosmetic results. Conclusion: Gasless endoscopic thyroidectomy via an axillary approach is feasible and safe and provides excellent cosmetic results with a minimal degree of postoperative complaints. This procedure provides another surgical option for the treatment of benign thyroid disease in selected patients. (Korean J Endocrine Surg 2005;5:81-86)