Endoscopic thyroidectomy for solitary thyroid nodules

Conventional thyroidectomy often leaves an undesirable scar on the anterior neck. The aim of this study was to assess the feasibility and efficacy of endoscopic thyroidectomy, a new minimally invasive technique for thyroid su rgery. Between September 1998 and February 2000, 18 patients with a solitar y thyroid nodule wtderwent endoscopic thyroidectomy utilizing CO2 insufflat ion. There were 16 females and 2 males with a mean age of 43 years (range 1 7-66 years), indications for surgery included indeterminate cytology (n = 8 ), follicular neoplasm (n = 8), Hurthle cell neoplasm (n = 1), and toxic th yroid nodule (n = 1). The mean nodule diameter was 2.7 cm (0.6-7 cm). Analg esic requirement, return to normal activity, and cosmetic results were comp ared to 18 consecutive patients who had conventional thyroidectomy. Sixteen of 18 cases were successfully completed endoscopically with a mean operati ng time of 220 minutes (range, 120-330 minutes). There were no major compli cations, but 3 patients developed mild hypercarbia and 1 patient had an inc idental parathyroidectomy. When compared to conventional thyroidectomy, pat ients undergoing endoscopic thyroidectomy had a significantly superior cosm etic result (p < 0.005) and a quicker return to normal activity (p < 0.05), but there was no difference in analgesic requirement. Endoscopic thyroidec tomy is a technically feasible and safe procedure that leads to an improved cosmetic result and a quicker recovery. Open completion thyroidectomy is r ecommended for thyroid carcinoma until more data are available.