Endoscopic Thyroidectomy for Large-Sized Goiters: Merits of the Axillo-Breast Approach with Gas Insufflation
Table 1
Demographic, clinicopathological, and perioperative characteristics of the patients of the study.
Parameter
Value
Age:
Range
20–61 years
Mean + SD
34.75 ± 11.39 years
Sex:
Female
30
Male
3
Comorbidities:
Smoking
2
Hypertension
4
Diabetes
3
Morbid obesity
3
Other chronic illnesses such as hepatic, cardiac, and renal
0
Preoperative thyroid function:
Euthyroid
29
Clinical hypothyroidism
3
Controlled toxic adenoma
1
Preoperative sonographic characters of nodule(s):
Side (right/left)
19/14
Number (single/multiple)
27/6
Dominant nodule greatest dimension:
Range
3–9.5 cm
Mean ± SD
5.29 ± 1.48 cm
TIRAD scoring (T3/T4a/T4b)
(22/8/3)
Preoperative sonographic volume of pathological lobe in ml:
Range
60.11–236.88 ml
Mean
101.86 ± 54.45 ml
Preoperative FNAC:
Bethesda 1 (no, %)
1 (3%)
Bethesda 2 (no, %)
22 (66.8%)
Bethesda 3 (no, %)
7 (21.2%)
Bethesda 4 (no, %)
3 (9%)
Operative time:
Range
95–165 minutes
Mean + SD
110.76 ± 18.75 minutes
Estimated blood loss:
Range
10–35 ml
Mean + SD
16.97 ± 7.28 ml
Total drain output:
Range
50–110 ml
Mean + SD
86.13 ± 18.00 ml
RLN visualization (no, %)
All (33) patients
EBSLN visualization (no, %)
10 cases (30.30%)
RLN affection:
Temporary (no)
One patient
Permanent (no)
No patient
Hospital stays:
2 days (no)
All (33) patients
More than 2 days (no)
0 patient
Mean drain output over the first 4 PO days (ml):
Range
50–100 ml
Mean + SD
76.36 ± 15.58 ml
Paresthesia in neck/upper anterior chest wall:
No paresthesia (no)
8 (24.24%)
Temporary (no)
25 (75.75%)
Permanent (no)
0 (0%)
Mean postoperative subjective pain scores:
POD1
4.03
POD2
2.66
POD3
1.33
POD7
0.35
Neck contracture:
No neck contracture (no)
28
Temporary (no)
5
Permanent (no)
0
Seroma
2 cases, managed by aspiration
Intraoperative hemorrhage or postoperative hematoma
0
Wound complications:
Cellulitis
3
Wound gapping
0
Infection with discharge
0
Hypertrophic scar
2
Keloid
0
Completion thyroidectomy:
Required (no)
2
No required (no)
31
Postoperative pathology:
Benign:
Thyroid follicular nodular disease
25
Follicular adenoma
3
Low risk neoplasms:
NIFTP
2
Malignant:
Unifocal papillary microcarcinoma
2
Multifocal papillary microcarcinoma
1
Follicular carcinoma (reaching the capsule with 4 vessels invasion)
1
Patient satisfaction:
Extremely satisfied (no, %)
29 (87.87%)
Satisfied (no, %)
4 (12.12%)
Acceptable (no, %)
0
Dissatisfied (no, %)
0
SD: standard deviation, EBSLN: external branch of superior laryngeal nerve, POD: postoperative day, and NIFTP: noninvasive follicular tumor with papillary-like nuclear features.
