Comparison of the endoscopic thyroidectomy via areola approach and open thyroidectomy: A propensity score matched cohort study of 302 patients in the treatment of papillary thyroid non-microcarcinoma
BackgroundThe endoscopic thyroidectomy via areola approach (ETAA) is widely used in patients with benign thyroid tumors and papillary thyroid microcarcinoma (PTMC). Its safety and complication rates are reported to be similar to open thyroidectomy (OT). This study aimed to evaluate the safety and fe...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-02-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1081835/full |
| _version_ | 1828002497800699904 |
|---|---|
| author | Yujun Li Zhaodi Liu Zhuolin Song Yong Wang Xing Yu Ping Wang |
| author_facet | Yujun Li Zhaodi Liu Zhuolin Song Yong Wang Xing Yu Ping Wang |
| author_sort | Yujun Li |
| collection | DOAJ |
| description | BackgroundThe endoscopic thyroidectomy via areola approach (ETAA) is widely used in patients with benign thyroid tumors and papillary thyroid microcarcinoma (PTMC). Its safety and complication rates are reported to be similar to open thyroidectomy (OT). This study aimed to evaluate the safety and feasibility of ETAA, compared with OT, in patients with papillary thyroid non-microcarcinoma (PTNMC).MethodsWe retrospectively reviewed all patients with PTNMC who underwent ETAA or OT in our hospital from January 2017 to December 2021. A total of 302 patients were matched at a ratio of 1:1 by the propensity score matching (PSM) analysis and surgical outcomes. Safety and feasibility were analyzed between two groups.ResultsBefore PSM, patients in the ETAA group were younger (p < 0.001) and had a larger proportion of female patients (p < 0.001) with a lower BMI (p < 0.001) compared with the OT group. The ETAA group also had a higher proportion of unilateral thyroidectomy (p = 0.002). PSM was used to create a highly comparable control group. After PSM, the ETAA group had a longer operative time (p < 0.001), larger blood loss (p = 0.046) and total drainage amount (p = 0.035), with higher C-reactive protein (p = 0.023) and better cosmetic outcomes (p < 0.001). There were no significant differences in the following clinicopathologic characteristics: number of dissected positive lymph nodes, rate of recurrent laryngeal nerve signal weakened, parathyroid autotransplantation, postoperative pain, hospital stay, complications, and oncologic completeness. There was no patient converted to OT in the ETAA group and two patients suffered from persistence/recurrence in the follow-up.ConclusionETAA is a safe and feasible surgical approach for patients with PTNMC. |
| first_indexed | 2024-04-10T06:45:19Z |
| format | Article |
| id | doaj.art-9ca04dd4cf1d44369b7165d790505e9d |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-10T06:45:19Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-9ca04dd4cf1d44369b7165d790505e9d2023-02-28T13:11:21ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-02-011310.3389/fonc.2023.10818351081835Comparison of the endoscopic thyroidectomy via areola approach and open thyroidectomy: A propensity score matched cohort study of 302 patients in the treatment of papillary thyroid non-microcarcinomaYujun LiZhaodi LiuZhuolin SongYong WangXing YuPing WangBackgroundThe endoscopic thyroidectomy via areola approach (ETAA) is widely used in patients with benign thyroid tumors and papillary thyroid microcarcinoma (PTMC). Its safety and complication rates are reported to be similar to open thyroidectomy (OT). This study aimed to evaluate the safety and feasibility of ETAA, compared with OT, in patients with papillary thyroid non-microcarcinoma (PTNMC).MethodsWe retrospectively reviewed all patients with PTNMC who underwent ETAA or OT in our hospital from January 2017 to December 2021. A total of 302 patients were matched at a ratio of 1:1 by the propensity score matching (PSM) analysis and surgical outcomes. Safety and feasibility were analyzed between two groups.ResultsBefore PSM, patients in the ETAA group were younger (p < 0.001) and had a larger proportion of female patients (p < 0.001) with a lower BMI (p < 0.001) compared with the OT group. The ETAA group also had a higher proportion of unilateral thyroidectomy (p = 0.002). PSM was used to create a highly comparable control group. After PSM, the ETAA group had a longer operative time (p < 0.001), larger blood loss (p = 0.046) and total drainage amount (p = 0.035), with higher C-reactive protein (p = 0.023) and better cosmetic outcomes (p < 0.001). There were no significant differences in the following clinicopathologic characteristics: number of dissected positive lymph nodes, rate of recurrent laryngeal nerve signal weakened, parathyroid autotransplantation, postoperative pain, hospital stay, complications, and oncologic completeness. There was no patient converted to OT in the ETAA group and two patients suffered from persistence/recurrence in the follow-up.ConclusionETAA is a safe and feasible surgical approach for patients with PTNMC.https://www.frontiersin.org/articles/10.3389/fonc.2023.1081835/fullpapillary thyroid non-microcarcinomaendoscopic thyroidectomy via areola approachsafetyfeasibilitycosmetic outcome |
| spellingShingle | Yujun Li Zhaodi Liu Zhuolin Song Yong Wang Xing Yu Ping Wang Comparison of the endoscopic thyroidectomy via areola approach and open thyroidectomy: A propensity score matched cohort study of 302 patients in the treatment of papillary thyroid non-microcarcinoma Frontiers in Oncology papillary thyroid non-microcarcinoma endoscopic thyroidectomy via areola approach safety feasibility cosmetic outcome |
| title | Comparison of the endoscopic thyroidectomy via areola approach and open thyroidectomy: A propensity score matched cohort study of 302 patients in the treatment of papillary thyroid non-microcarcinoma |
| title_full | Comparison of the endoscopic thyroidectomy via areola approach and open thyroidectomy: A propensity score matched cohort study of 302 patients in the treatment of papillary thyroid non-microcarcinoma |
| title_fullStr | Comparison of the endoscopic thyroidectomy via areola approach and open thyroidectomy: A propensity score matched cohort study of 302 patients in the treatment of papillary thyroid non-microcarcinoma |
| title_full_unstemmed | Comparison of the endoscopic thyroidectomy via areola approach and open thyroidectomy: A propensity score matched cohort study of 302 patients in the treatment of papillary thyroid non-microcarcinoma |
| title_short | Comparison of the endoscopic thyroidectomy via areola approach and open thyroidectomy: A propensity score matched cohort study of 302 patients in the treatment of papillary thyroid non-microcarcinoma |
| title_sort | comparison of the endoscopic thyroidectomy via areola approach and open thyroidectomy a propensity score matched cohort study of 302 patients in the treatment of papillary thyroid non microcarcinoma |
| topic | papillary thyroid non-microcarcinoma endoscopic thyroidectomy via areola approach safety feasibility cosmetic outcome |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1081835/full |
| work_keys_str_mv | AT yujunli comparisonoftheendoscopicthyroidectomyviaareolaapproachandopenthyroidectomyapropensityscorematchedcohortstudyof302patientsinthetreatmentofpapillarythyroidnonmicrocarcinoma AT zhaodiliu comparisonoftheendoscopicthyroidectomyviaareolaapproachandopenthyroidectomyapropensityscorematchedcohortstudyof302patientsinthetreatmentofpapillarythyroidnonmicrocarcinoma AT zhuolinsong comparisonoftheendoscopicthyroidectomyviaareolaapproachandopenthyroidectomyapropensityscorematchedcohortstudyof302patientsinthetreatmentofpapillarythyroidnonmicrocarcinoma AT yongwang comparisonoftheendoscopicthyroidectomyviaareolaapproachandopenthyroidectomyapropensityscorematchedcohortstudyof302patientsinthetreatmentofpapillarythyroidnonmicrocarcinoma AT xingyu comparisonoftheendoscopicthyroidectomyviaareolaapproachandopenthyroidectomyapropensityscorematchedcohortstudyof302patientsinthetreatmentofpapillarythyroidnonmicrocarcinoma AT pingwang comparisonoftheendoscopicthyroidectomyviaareolaapproachandopenthyroidectomyapropensityscorematchedcohortstudyof302patientsinthetreatmentofpapillarythyroidnonmicrocarcinoma |