The analysis of endoscopic-assisted neck minimally invasive thyroid surgery (Experience of 1007 cases)

The endoscopic-assisted neck minimally invasive thyroid surgery is one of the main directions of development of thyroid surgery in recent years. The greatest significance of this kind of operation is to solve the patient's disease by a truly minimally invasive and cosmetic way, which is in accordance with modern requirements for high-quality living standards and aesthetic views. We will discuss skills of endoscopic assisted neck minimally invasive thyroid surgery and summarize surgical indicators and relevant experience in this article. Methods To retrospectively analyze clinical data of 1007 cases (727 women and 280 men with a mean age of 34 years) of endoscopic-assisted neck minimally invasive thyroid surgery in The First Hospital of Jilin University in China from June, 2006 to January, 2012. The operation was performed under general anesthesia and tracheal intubation, and we use the Miccoli's technique during the whole surgery. During surgical procedure, we recorded operation time , blood loss, incision size, the postoperative drainage, beauty score, whether the use of analgesics, postoperative time to discharge, hospitalization costs, with or without tumor recurrence , wound infection and other complications . Results 1007 patients were all successfully operated by endoscopic-assisted neck minimally invasive thyroid surgery. The mean operative time of the first 50 cases was (60 ± 13) min; A mean operative time of later 957 cases was (39±9) min. 15-80mL of intra-operative blood loss and 5-5mL of postoperative drainage were confirmed. After two days drainage tubes were removed. Postoperative hospital stay was (3±1) d. The incision size was 2.0-3.5cm. Patients were all satisfied with the scar. After surgery all cases did not use painkillers. 3 cases occurred postoperative transient hoarseness, 1 case occurred subcutaneous emphysema, 12 cases transferred to open surgery because of thyroid carcinoma with cervical lymph node metastasis. All cases had no postoperative bleeding or infection. The whole group were followed up for 3 to 60 months, no recurrences happened. Conclusions Endoscopic-assisted neck minimally invasive thyroid surgery is a practical, low invasive surgery, which has advantages of safety, reliability, less bleeding, less pain, shorter hospital stay, fewer complications and relative cosmetic results. On the basis of mastering certain skills, it has better clinical effects and brighter application prospect.