OBJECTIVE
To study our own results of performing endoscopic hemithyroidectomy through «gasless» axillary approach in comparison with the results of traditional open operations on the thyroid gland of the corresponding volume.
MATERIAL AND METHODS
The results of surgical treatment of 68 patients with thyroid diseases were studied. The study group consisted of 33 patients who underwent endoscopic hemithyroidectomy through «gasless» axillary approach. The control group included 35 patients who underwent open hemithyroidectomy.
RESULTS
During endoscopic operations, there was an increase in the average duration of the intervention (159.5±62.1 versus 54.6±15.7 min; p<0.01), the time of postoperative drainage (3.4±0.5 versus 1.2±0.5 days; p<0.05), drainage volume (207.5±58.2 versus 25.5±7.1 ml; p<0.05) and duration of hospitalization (6.4±1.3 versus 4.1±1.6 days; p<0.05). The volume of intraoperative blood loss (21.2±8.8 versus 19.7±7.9 ml; p>0.05) and the duration of the need for postoperative parenteral anesthesia (2.3±0.5 versus 2.5±0.6 days; p>0.05) were comparable between groups. The overall complication rate was higher in the study group (27.3% versus 5.7%; p<0.05), however, the difference was associated with the incidence of brachial plexitis (7 cases; 21.2%) due to the characteristics of surgical approach and duration of operation. At the same time, during the first 17 operations, plexitis was recorded in 6 patients (35.3%), and in the subsequent 16 operations, plexitis was noted in only 1 case (6.3%). Patients in the study group were significantly more satisfied with the treatment in general and the cosmetic outcome of the operation in particular. Overall satisfaction with the treatment with a score of «5» was noted by 72.7% of patients after endoscopic surgery and by 25.7% of patients after traditional intervention (p<0.01). The cosmetic result was rated with a score of «5» by 81.8% and 8.6% of patients, respectively (p<0.01).
CONCLUSION
Endoscopic hemithyroidectomy through «gasless» axillary approach in comparison with traditional surgery is characterized by a comparable level of efficacy and safety in terms of the risk of complications specific to thyroid surgery. The early postoperative period after endoscopic hemithyroidectomy is characterized by a longer course, however, in the long-term postoperative period, patients demonstrate a significantly higher level of satisfaction with the cosmetic outcome of the operation and with the treatment in general.
