Abstract

*M. S. Abdelhamid, H. A. Nafady, A. M. Bacheet, A. M. Rashad, A. S. Abdel Gayd and T. M. Elgaabary

ABSTRACT

Background: Thyroidectomies using the open method are effective, well-tolerated and safe but involve transverse incision on the neck measuring 7–10 cm in length. Thyroid disorders are more common in women and they find these scars uncomfortable and cosmetically unacceptable. Hence, minimal access approaches are playing an ever increasing role in neck surgery as they result in a reduction in size or elimination of the scar on the neck The aim of this study is to compare between Transareolar endoscopic thyroidectomy and conventional open thyroidectomy regarding the feasibility, safety of surgical outcome, complications. Patients and methods This prospective study was carried out in Beni-suef University Hospital between January 2017 and December2017, after the patients fitted both the inclusions and exclusions criteria. This study was enrolling 40 co-operative patients aged 18-60 years with unilateral thyroid lobe nodule, nodules or diffuse swelling with the largest diameter less than 4 cm. 20 patients went transareolar thyroid lobectomy and 20 went open thyroid lobectomy Thyroid nodules less than 4-cm in their largest transverse diameter.Thyroid gland volume less than 20-ml as estimated by US.Cranio-caudal axis of the lobes must not exceed 7-cm. Results The mean operative time was90 min (57 -135) minutes for transareolar thyroid lobectomy while it was 70 min(40 -90)minutes for open thyroid lobectomy, The LOS was 24 hours in transareolar and 72 hours in the open method . No RLN injury, no tracheal injury no esophageal injury, no bleeding in both methods. There were one SLN injury, one seroma, and 2 wound complications in open lobectomy. Conclusion: we demonstrated that thyroidectomy through Transareolar endoscopic approach is technically feasible, safe, and minimally invasive procedure with excellent cosmetic results. Although the number of patients that we have treated in this manner is still small, we believe that the procedure constitutes a useful surgical treatment for thyroid disease as it is superior to open approach regarding cosmesis and invasiveness.