Outcomes of endoscopic hemithyroidectomy via axillary–breast– shoulder approach in benign thyroid nodules

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Background: Endoscopic thyroidectomy via the axillary, anterior, and breast approaches has been introduced in manyindividual surgical institutions around the world. The unilateral axillo-breast approach is a surgical resection of the thyroidlobe remotely from the neck without a neck scar shifting the scar to an area that is covered by clothing. Endoscopicthyroidectomy requires meticulous surgical dissection, absolute hemostasis, en bloc tumor resection, and adequatevisualization of the operative field.Aim: To assess the feasibility and safety of endoscopic hemithyroidectomy via the axillary–breast–shoulder (ABS)approach in the management of solitary thyroid nodules and subsequent complications of this procedure.Patients and Methods: In all, 25 individuals with benign solitary thyroid nodules smaller than 5 cm in one lobe wereincluded in our study. All patients have opted for endoscopic thyroid surgery. Using fine-needle aspiration cytology, thepatients included met the benign criteria (FNAC). Within 48 h, we used a visual analog scale to assess postoperativediscomfort. Assessment of the patient’s satisfaction with the cosmetic outcomes was made 1, 3, and 6 months followingsurgery.Results: The majority of studied cases (23 cases) had no intraoperative complications, while two cases had eitherecchymosis or emphysema. There was a statistically significant difference as regards cosmetic results change duringfollow-up between 1 month and 3 months, between 1 month and 6 months, and between 3 and 6 months. There was astatistically significant difference as regards VAS change during follow-up between 12 and 24 h, between 12 and 48 h,and between 24 and 48 h.Conclusion: This study provided evidence that, in certain individuals with benign thyroid disease, endoscopicthyroidectomy via ABS route is a safe, successful treatment that yields great esthetic outcomes. The ABS technique is aviable, safe, and aesthetically pleasing substitute for a traditional open thyroidectomy.

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