Endoscopic thyroidectomy for solitary nodules

Introduction. – The aim of this study was to assess the feasibility and safety of endoscopic thyroidectomy.Materials and methods. – Between September 1998 and February 2000, 18 patients with a solitary thyroid nodule underwent endoscopic thyroidectomy in a single institution. Analgesic requirement, return to normal activity, and cosmetic results were compared to 18 consecutive patients who had conventional thyroidectomy.Results. – Sixteen females and two males, with a mean age of 43 years (17–66 years) were operated on. Indications for surgery included indeterminate cytology (n = 8), follicular neoplasm (n = 8), Hu¨rthle cell neoplasm (n = 1), and toxic thyroid nodule (n = 1). The mean nodule diameter was 2.7 cm (0.6–7 cm). Sixteen of 18 cases were successfully completed endoscopically with a mean operating time of 220 min (120–330 min). There were no major complication, but three patients developed mild hypercarbia and one patient had an incidental parathyroidectomy. When compared to conventional thyroidectomy, patients undergoing endoscopic thyroidectomy had a significantly superior cosmetic result (P < 0.005) and a quicker return to normal activity (P < 0.05), but there was no difference in analgesic requirement.Conclusion. – The results of this study seem to confirm that endoscopic thyroidectomy is a technically feasible and safe procedure that leads to an improved cosmetic result and a quicker recovery. However, conventional thyroidectomy is still recommended when thyroid carcinoma is suspected. [Copyright &y& Elsevier]