Scarless endoscopic thyroidectomy (SET) lateral neck dissection for papillary thyroid carcinoma through breast approach: 10 years of experience

Background Breast approach endoscopic thyroidectomy with lateral neck lymph node metastases dissection has been described. However, in this article, we report on 10 years' experience with the breast approach to patients with endoscopic thyroidectomy with level II, III, and IV lateral neck dissection (LND). Patients with papillary thyroid carcinoma (PTC) who received scarless endoscopic thyroidectomy (SET) were included to evaluate its therapeutic effect. Methods Between June 2009 and June 2019, we selected 155 patients with PTC with level II, III, or IV level lymph node metastasis suspected. Ipsilateral level II, III, and IV dissection was performed, accompanied by thyroidectomy and central compartment dissection. In addition, 102 patients received conventional open LND during the same period and were included. Clinicopathological characteristics, outcomes, and tumor prognosis were retrospectively compared in the two groups. Results During the 10 years, the submitted patients' clinicopathological characteristics including tumor size, tumor stage, retrieved lymph nodes number, complication rates, postoperative PTH, and mean postoperative hospital stay were similar between the SET and open group. The mean operating time in the SET group (278.2 +/- 38.6 min) was longer than in the open group (179.3 +/- 25.4 min). The recurrent rate was not significantly different (2/155, 2/106) in the SET and conventional open group. Conclusion The safety and oncological completeness dissection of SET was similar to that of open procedures. SET is an effective treatment approach for patients with PTC having cosmetic results' demand of lateral neck lymph node metastases.