Transaxillary Endoscopic Hemithyroidectomy versus Open Hemithyroidectomy for Solitary Thyroid Nodule: A Randomized Study

Introduction: Traditional thyroidectomy technique approaches the thyroid through a transverse incision over the neck. The scar may result in hyperesthesia, restriction of neck movements, and increased patient self-consciousness. Furthermore, in some patients, it can result in hyperplastic or keloid scar formation. Minimally invasive techniques have replaced open surgeries in many surgical fields. Endoscopic transaxillary thyroidectomy is one such minimally invasive technique that may provide superior cosmetic results for patients needing thyroidectomy. Materials and Methods: We did a randomized study comparing endoscopic transaxillary versus traditional open hemithyroidectomy approach in case of a solitary thyroid nodule. We reviewed our series of 57 patients and studied the feasibility and safety of transaxillary endoscopic approach in patients who have undergone hemithyroidectomy between the years 2012 and 2015. Results: The total operative time for the transaxillary endoscopic hemithyroidectomy (TAEHT) is longer compared to the open group. Total operating time was calculated from the time of skin incision to closure. Mean operating time in transaxillary endoscopic group is 132 min and mean operating time in open hemithyroidectomy group is 102.03 min. In comparison, the mean operating time in open hemithyroidectomy is 45.4 +/- 11.90. Conclusion: TAEHT is safe and feasible. However, there is a slight increase in operative time. We also conclude that transaxillary endoscopic thyroidectomy is superior to conventional open hemithyroidectomy in terms of post-operative pain, duration of stay, seroma formation, and cosmesis.