# Endoscopic thyroidectomy via chest-collarbone approach versus conventional open thyroidectomy: a retrospective comparative study

## TL;DR

A new endoscopic thyroid surgery method using the chest-collarbone approach is safe, effective, and offers better cosmetic results than traditional open surgery.

## Contribution

The chest-collarbone approach is introduced as a novel endoscopic method for thyroidectomy with improved cosmetic outcomes.

## Key findings

- Endoscopic thyroidectomy via chest-collarbone approach is safe and feasible.
- The chest-collarbone approach provides better cosmetic outcomes compared to open thyroidectomy.
- Preoperative assessment of nodule size and nature significantly affects the success rate of the surgery.

## Abstract

•Endoscopic thyroidectomy through chest-collarbone approach is safe and feasible.•Chest-collarbone endoscopic thyroid surgery improves in a good cosmetic outcome.•Preoperative evaluation of nodule size and nature affects the success rate of surgery.

Endoscopic thyroidectomy through chest-collarbone approach is safe and feasible.

Chest-collarbone endoscopic thyroid surgery improves in a good cosmetic outcome.

Preoperative evaluation of nodule size and nature affects the success rate of surgery.

Endoscopic thyroidectomy, such as axillary, areola and transoral approaches, offer the advantage of a good cosmetic outcome, but it requires a wider dissection field compared to open thyroidectomy. Recently, chest-collarbone approach thyroidectomy has been widely developed in China because of its shorter anatomical route compared to other endoscopic approaches. This study retrospectively evaluated endoscopic thyroidectomy via chest-collarbone approach in patients with thyroid nodules to determine its feasibility.

A total of 46 patients with thyroid disease who underwent endoscopic thyroidectomy between January 2022 and December 2022 were enrolled in the study and randomly matched to patients with thyroid disease who underwent open thyroidectomy at the same time based on nodule size and pathology. Postoperative bleeding, hoarseness situation, hospital stay, postoperative drainage volume, laryngeal nerve palsy, hypoparathyroidism and wound infection were assessed in both groups.

Forty-four patients underwent endoscopic thyroidectomy successfully and two patients changed to open thyroidectomy. The amount of postoperative drainage for the endoscopic thyroidectomy group was 102.78 ± 28.04 mL, and which was 71.91 ± 19.20 for open thyroidectomy group (p < 0.001). The postoperative hospital stay for the endoscopic thyroidectomy group was 8.78 ± 2.57 days, and which was 7.22 ± 1.13 for open thyroidectomy group (p < 0.001). There was no significant difference in postoperative bleeding, hoarseness situation, and wound infection between the two groups. Laryngeal nerve palsy, supraclavicular nerve injury and hypoparathyroidism were not observed in any patient during this study.

Chest-collarbone endoscopic thyroid surgery is acceptable. This treatment improves in a good cosmetic outcome in patients with thyroid disease. To assess patients with preoperative nodule size and nature of the case is the impact of the success rate, which is particularly important.