Minimally Invasive Open Bilateral Total Thyroidectomy Using Unilateral Neck Incision in Thyroid Cancer: Preliminary Surgical and Quality of Life Outcomes

• Published in: Yonsei medical journal Vol. 65; no. 8; pp. 448 - 455
• Main Authors: Lee, In A, Kim, Minji, Kim, Jin Kyong, Lee, Cho Rok, Kang, Sang-Wook, Jeong, Jong Ju, Nam, Kee-Hyun, Chung, Woong Youn
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01.08.2024; 연세대학교의과대학
• Subjects: Adult; Female; Humans; Male; Middle Aged; Minimally Invasive Surgical Procedures - methods; Neck - surgery; Original; Postoperative Complications - epidemiology; Quality of Life; Retrospective Studies; Thyroid Cancer, Papillary - pathology; Thyroid Cancer, Papillary - surgery; Thyroid Neoplasms - pathology; Thyroid Neoplasms - surgery; Thyroidectomy - methods; Treatment Outcome; 의학일반; Minimally invasive thyroidectomy; patients' satisfaction with surgical wound; open bilateral total thyroidectomy; patients' quality of life
• ISSN: 0513-5796; 1976-2437; 1976-2437
• DOI: 10.3349/ymj.2023.0457

Thyroid cancer incidence has increased in recent decades, and thyroid surgery is continuously evolving in response to demands for postoperative comfort and cosmesis. This study aimed to introduce a new surgical method for minimally invasive open bilateral total thyroidectomy (MI-BTT) using a unilateral 2.5-3.0 cm neck incision. Furthermore, we reported the surgical outcomes and postoperative quality of life (QoL) using a validated Korean translated Dermatology Life Quality Index (DLQI) questionnaire. We retrospectively evaluated 41 Asian patients who underwent MI-BTT for low-risk papillary thyroid cancer by a single surgeon from March 2019 to December 2021. A total of 4 male and 37 female patients were included. The mean age and body mass index were 46.2±10.1 years and 23.3±3.3 kg/m², respectively. The average tumor size was 1.1±0.6 cm, and 36 patients (87.8%) had bilateral cancer. Twenty-three (56.1%) patients had occult central lymph node (CLN) metastasis in the final pathologic report, with the mean number of dissected CLNs being 7.2±6.5. Gross capsular extension was found in 6 patients (14.6%). Moreover, 28 patients (68.3%) received additional treatment after surgery with low or high doses of radioactive iodine. The average serum-stimulated thyroglobulin value identified during treatment was 1.57±2.30 ng/mL. The mean operation time was 78.0±13.9 minutes, and postoperative complications included transient hypocalcemia (36.6%), transient hoarseness (24.4%), and seroma (2.4%). The mean total DLQI score was 2.73±0.78, indicating a small effect on QoL. MI-BTT is a novel, safe, and feasible technique to improve patient satisfaction for surgical scars and QoL.