A Prospective, Comparative Study between Trans-Axillary and Trans-Oral Approaches to Endoscopic Thyroid Surgery at a Teaching Hospital in India

Abstract

Arvind Ghanghoria, Bhavesh Bang and Amiya Ankit*

Objective: To assess the outcome between trans-oral and trans-axillary endoscopic hemithyroidectomy in terms of cosmesis and complications.

Methods: Prospective observational study with 30 patients, 15 of whom underwent trans-axillary while other 15 underwent trans-oral hemithyroidectomy. Inclusion criteria were solitary benign thyroid nodule, less than 4 cm in size and restricted to one lobe, requiring a hemithyroidectomy.

Results: Majority of the patients were female, with a nodule size between 2 cm-3 cm. The mean operating time was much higher in the trans-oral group. The trans-oral group had significantly lower pain score and drainage in the post-operative period, while the hospital stay was same in both groups at 5 days. Though the incidence of complications was much higher in the trans-oral group, most of the complications were rather minor and did not require any major intervention.

Conclusion: Both trans-oral and trans-axillary approaches to thyroid surgery are safe and the choice of technique should be based on the patient preference.