Endoscopic thyroidectomy by the breast approach: A single institution's 9-year experience

Background: The aim of this study was to evaluate the feasibility and cosmetic results of endoscopic thyroidectomy by the breast approach for patients with thyroid diseases. Methods: From August 1998 to July 2007, 92 patients with benign thyroid diseases underwent endoscopic thyroidectomy at our institution. Of these patients, 54 underwent thyroid lobectomy for a thyroid nodule, and 38 selected subtotal thyroidectomy for Graves' disease. Results: Ninety of the 92 procedures were successfully completed endoscopically. Mean operative time for thyroid lobectomy and subtotal thyroidectomy was 121.1 min and 231.9 min, repectively. Postoperative complications included one wound infection, one transient and one permanent recurrent laryngeal nerve palsy, one transient hypocalcemia, and five hypertrophic scars in the right breast medial margin. At 84 months of follow-up, one patient reported paresthesia in the anterior chest and one had experienced swallowing discomfort. Patient satisfaction was recorded as "satisfied," "equivocal," and "unsatisfied" in 54, 2, and 0 patients. Mean satisfaction score was 9.7, 9.5, 9.5, and 8.9 points in patients in their teens, 20s, 30s, and 40s, respectively, with an overall mean score of 9.3 points, showing more satisfaction in the young. Conclusions: Endoscopic thyroidectomy by the breast approach for patients with thyroid diseases is an effective procedure that allows an excellent cosmetic result.