P Cougard1, L Osmak, P Esquis, P Ognois. 1. Service de chirurgie générale et endocrinienne hôpital général CHU de Dijon, 3, rue du Faubourg Raines, 21000 Dijon, France. patrick.cougard@chu-dijon.fr
Abstract
AIM OF THE STUDY: To demonstrate the feasibility of endoscopic thyroidectomy for unilateral lobectomy and isthmectomy. MATERIAL AND METHODS: [corrected] This prospective study included 40 patients operated on between January 1999 and March 2005 by a total endoscopic approach. Only lobectomies and isthmectomies were performed for nodules inferior to 3 cm in diameter. RESULTS: Forty patients (36 females, 4 males) underwent 35 lobectomies and five isthmectomies. Twenty-four patients were operated on without ultrasonic shears (US) the rate of conversion in this group was 33%. Sixteen patients were operated on with US: the rate of conversion was 0%. In the second group, the operative time was decreasing to the half, range 45 to 90 minutes. In both the two groups, there were no morbidity: no extensive emphysema, no hematoma, no wound abscess, no cord vocal palsy. The median hospital stay was 1,75 days. After three months of follow up, all the patients were satisfied, especially concerning the cosmetic results and the short recovery time. CONCLUSIONS: Endoscopic thyroidectomy is feasible and safe for performing lobectomies and isthmectomies. In the near future, it could be extended to bilateral goitres in selected patients.
AIM OF THE STUDY: To demonstrate the feasibility of endoscopic thyroidectomy for unilateral lobectomy and isthmectomy. MATERIAL AND METHODS: [corrected] This prospective study included 40 patients operated on between January 1999 and March 2005 by a total endoscopic approach. Only lobectomies and isthmectomies were performed for nodules inferior to 3 cm in diameter. RESULTS: Forty patients (36 females, 4 males) underwent 35 lobectomies and five isthmectomies. Twenty-four patients were operated on without ultrasonic shears (US) the rate of conversion in this group was 33%. Sixteen patients were operated on with US: the rate of conversion was 0%. In the second group, the operative time was decreasing to the half, range 45 to 90 minutes. In both the two groups, there were no morbidity: no extensive emphysema, no hematoma, no wound abscess, no cord vocal palsy. The median hospital stay was 1,75 days. After three months of follow up, all the patients were satisfied, especially concerning the cosmetic results and the short recovery time. CONCLUSIONS: Endoscopic thyroidectomy is feasible and safe for performing lobectomies and isthmectomies. In the near future, it could be extended to bilateral goitres in selected patients.
Authors: Pier Francesco Alesina; Thomas Rolfs; Katrin Rühland; Violetta Brunkhorst; Harald Groeben; Martin K Walz Journal: Langenbecks Arch Surg Date: 2010-07-14 Impact factor: 3.445