Skip to main content
SpringerLink
Log in

A Comparative Study of Clinicopathological Profile and Surgical Outcomes of Endoscopic (Bilateral Axillo-Breast Approach) Versus Conventional Total Thyroidectomy for Thyroid Tumors

  • Original Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

Surgical techniques are evolving more rapidly than ever. Minimal access endocrine surgery is the latest amalgamation of technology and surgical skills. Endoscopic thyroid surgery is usually demanded by young patients to avoid neck scar. The aim of this study was to review our experience and compare outcomes of endoscopic total thyroidectomy (ETT) using bilateral axillo-breast approach (BABA) with conventional open total thyroidectomy (COT), performed during January 2015–December 2018. Patients were divided into 2 groups: group A, through ETT, and group B, through COT. A total of 40 patients underwent ETT and 121 COT. There was no difference in both group in terms of age (median 38 years in group A vs 42 years in group B; p = 0.209) and gender (M:F = 1, 12.33 in group A vs 1:8.31 in group B; p = 0.763). Mean tumor size was significantly less in group A (3.90 cm in group A and 4.55 cm in group B; p = 0.048). Forty-five percent of patients developed transient hypocalcemia in group A, and 12.5% required IV calcium, whereas in group B, 52.89% of patients developed transient hypocalcemia, and 17.36% of patient required IV calcium. There was no permanent hypocalcemia in both groups. One (2.5%) patient had permanent voice change in ETT group. Increased postoperative stay (5.18 days in group A and 4.03 days in group B; p = <0.001) and operating time (median 195 min in group A and 165 min in group B; p = <0.001) in group A. A total of 11 patients had surgery for differentiated thyroid carcinoma in group A and 29 in group B. Postoperative parameters were comparable in both groups. Endoscopic procedures can be safely applied in various thyroid disease, even in larger goiter and malignant diseases. Although operating time, drainage, and hospital stay are longer in ETT, but perioperative outcomes are comparable with open surgeries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Availability of Data and Material

Available from corresponding author upon request.

References

  1. Cao F, Xie B, Cui B et al (2011) Endoscopic vs. conventional thyroidectomy for the treatment of benign thyroid tumors: a retrospective study of a 4-year experience. Exp Ther Med 2:661–666

    Article  Google Scholar 

  2. Alramadhan M, Choe JH, Lee JH, Choe JH, Lee JH, Kim JH, Kim JS (2017) Propensity score-matched analysis of the endoscopic bilateral axillo-breast approach (BABA) versus conventional open thyroidectomy in patients with benign or intermediate fine-needle aspiration cytology results, a retrospective study. Int J Surg 48:9–15

    Article  Google Scholar 

  3. Kumari R (2016) Goiter prevalence in children in North India region. Asian J Biomed Pharmaceut Sci 6:39

    Google Scholar 

  4. Arora A, Swords C, Garas G, Chaidas K, Prichard A, Budge J, Davies DC, Tolley N (2016) The perception of scar cosmesis following thyroid and parathyroid surgery: a prospective cohort study. Int J Surg 25:38–43

    Article  Google Scholar 

  5. Johri G, Chand G, Gupta N, Sonthineni C, Mishra A, Agarwal G, Mayilvaganan S, Verma AK, Mishra SK (2018) Feasibility of endoscopic thyroidectomy via axilla and breast approaches for larger goiters: widening the horizons. J Thyroid Res 2018:4057542–4057548. https://doi.org/10.1155/2018/4057542

    Article  PubMed  PubMed Central  Google Scholar 

  6. Chand G, Johri G (2019, 2019) Extracervical endoscopic thyroid surgery via bilateral axillo-breast approach (BABA). J Minim Access Surg. https://doi.org/10.4103/jmas.JMAS_260_18

  7. Huscher CSG (1997) Endoscopic right thyroid lobectomy. Surg Endosc 11:877

    Article  CAS  Google Scholar 

  8. Ikeda Y, Takami H, Sasaki Y, Kan S, Niimi M (2000) Endoscopic neck surgery by the axillary approach. J Am Coll Surg 191:336–340

    Article  CAS  Google Scholar 

  9. Shimazu K, Shiba E, Tamaki Y, Takiguchi S, Taniguchi E, Ohashi S, Noguchi S (2003) Endoscopic thyroid surgery through the axillo-bilateral-breast approach. Surg Laparosc Endosc Percutan Tech 13:196–201

    Article  Google Scholar 

  10. Choe JH, Kim SW, Chung KW et al (2007) Endoscopic thyroidectomy using a new bilateral axillo-breast approach. World J Surg 31:601–606

    Article  Google Scholar 

  11. Berber E, Bernet V, Fahey TJ III, American Thyroid Association Surgical Affairs Committee et al (2016) American Thyroid Association statement on remote-access thyroid surgery. Thyroid 26:331–337

    Article  Google Scholar 

  12. Choi JY, Lee KE, Chung KW (2012) Endoscopic thyroidectomy via bilateral axillo-breast approach (BABA): review of 512 cases in a single institute. Surg Endosc 26:948–955

    Article  Google Scholar 

  13. Maeda T, Saito M, Otsuki N, Morimoto K, Takahashi M, Iwaki S, Inoue H, Tomoda C, Miyauchi A, Nibu KI (2013) Voice quality after surgical treatment for thyroid cancer. Thyroid 23:847–853

    Article  Google Scholar 

  14. Iyomasa RM, Tagliarini JV, Rodrigues SA, Tavares ELM, Martins RHG (2019) Laryngeal and vocal alterations after thyroidectomy. Braz J Otorhinolaryngol 85:3–10

    Article  Google Scholar 

  15. Chand G, Agarwal S, Mishra A, Agarwal G, Verma AK, Mishra SK, Agarwal A, Kumar A (2018) The impact of uniform capsular dissection technique of total thyroidectomy on postoperative complications: an experience of more than 1000 total thyroidectomies from an endocrine surgery training centre in North India. Indian J Endocrinol Metab 22:362–367

    Article  Google Scholar 

  16. Chung YS, Choe JH, Kang KH et al (2007) Endoscopic thyroidectomy for thyroid malignancies: comparison with conventional open thyroidectomy. World J Surg 31:2302–2306

    Article  Google Scholar 

  17. Cao F, Jin K, Cui B et al (2013) Learning curve for endoscopic thyroidectomy: a single teaching hospital study. Onco Targets Ther 6:47

    PubMed  PubMed Central  Google Scholar 

  18. Cho MJ, Park KS, Cho MJ et al (2015) A comparative analysis of endoscopic thyroidectomy versus conventional thyroidectomy in clinically lymph node negative thyroid cancer. Ann Surg Treat Res 88:69–76

    Article  Google Scholar 

  19. Zhou X, Liao Y, Li H et al (2016) Dendritic cell vaccination enhances antiangiogenesis induced by endostatin in rat glioma. J Cancer Res Ther 12:198

    Article  CAS  Google Scholar 

  20. Park KN, Jung CH, Mok JO et al (2016) Prospective comparative study of endoscopic via unilateral axillobreast approach versus open conventional total thyroidectomy in patients with papillary thyroid carcinoma. Surg Endosc 30:3797–3801

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Endocrine Surgery, SGPGIMS, Lucknow, 226014, India

    Nitish Gupta, Gyan Chand, Anjali Mishra, Sabaretnam M, Gaurav Agarwal, Amit Agarwal & Saroj K. Mishra

Authors
  1. Nitish Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gyan Chand
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anjali Mishra
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sabaretnam M
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gaurav Agarwal
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Amit Agarwal
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Saroj K. Mishra
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Nitish Gupta was involved in manuscript preparation and data collection. Gyan Chand and Anjali Mishra conceptualized the study, involved in manuscript preparation, reviewing, and finalizing the manuscript. Sabaretnam M, Gaurav Agarwal, Amit Agarwal, and S K Mishra critically analyzed the manuscript and finalized it.

Corresponding author

Correspondence to Gyan Chand.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gupta, N., Chand, G., Mishra, A. et al. A Comparative Study of Clinicopathological Profile and Surgical Outcomes of Endoscopic (Bilateral Axillo-Breast Approach) Versus Conventional Total Thyroidectomy for Thyroid Tumors. Indian J Surg 83, 194–200 (2021). https://doi.org/10.1007/s12262-020-02267-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-020-02267-y

Keywords

Search

Navigation