Complications and technical aspects of safe tissue dissection in endoscopic hemithyroidectomy

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OBJECTIVE

To analyze the complications following endoscopic hemithyroidectomy and to develop the principles of tissue dissection for safe surgical intervention.

MATERIAL AND METHODS

The results of surgical treatment of 136 patients were studied. The main group consisted of 44 patients who underwent endoscopic hemithyroidectomy through a «gasless» axillary approach (EH group). The first control group consisted of 45 patients who underwent minimally invasive video-assisted hemithyroidectomy (MIVAH group). The second control group consisted of 47 patients who underwent open hemithyroidectomy (OH group).

RESULTS. O

Verall complication rate was significantly higher in the EH group (20.5% vs. 6.4% in the OH group and 4.4% in the MIVAH group; p<0.05). In the EH group, Clavien—Dindo grade I complications occurred in 11.4% of cases. There were no similar complications in the control groups (p<0.05). Clavien—Dindo grade II complications occurred in 9.1% of patients in the EH group, 4.3% in the OH group and no similar events were identified in the MIVAH group (p>0.05). Clavien—Dindo grade III complications occurred in 1 (2.1%) case in the OH group and 2 (4.4%) cases in the MIVAH group. There were no Clavien—Dindo grade III complications in the EH group. Thus, minor complications prevailed in the EH group. Their incidence decreased along with accumulation of experience. Moreover, endoscopic procedure is safer regarding the risk of severe complications.

CONCLUSION

Endoscopic hemithyroidectomy is safe, and the proposed principles of tissue dissection can further increase surgical safety.

Keywords:

endoscopic hemithyroidectomy

thyroid gland

safe dissection

endocrine surgery

endoscopic surgery

Authors:

Kurganov I.A.

Russian University of Medicine

ORCID: 0000-0003-0968-3955

Usmanov I.S.

Russian University of Medicine

ORCID: 0000-0001-9068-9777

Mamistvalov M.Sh.

Russian University of Medicine

ORCID: 0000-0001-5277-484X

Emelyanov S.I.

Russian University of Medicine

RSCI AuthorID: 526110
Scopus AuthorID: 6603872681
ORCID: 0000-0002-2575-1842

Received:

17.01.2024

Accepted:

28.02.2024

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