Application of Straight Line Tunnel With Less Subcutaneous Separation in Transthoracic Endoscopic Thyroidectomy

The objective of this paper was to evaluate the value of straight-line tunnel application in transthoracic endoscopic thyroidectomy. Forty patients were given 3-port transthoracic endoscopic thyroidectomy from March 2011 to June 2014. Preoperative diagnoses found 20 cases of nodular goiter, 16 cases of adenoma, and 4 cases of thyroid calcification. We used a metal rod to free skin flap in a straight way toward the neck, and a straight-line tunnel was created to obtain a good view. All 40 cases involving endoscopic thyroidectomy were performed successfully, 28 were performed with unilateral subtotal thyroidectomy, 5 were performed with unilateral thyroidectomy, 5 were performed with bilateral partial thyroidectomy, and 2 were performed with radical thyroidectomy for carcinoma. One is anaplastic thyroid carcinoma (ATC) and the other is follicular thyroid carcinoma. Operation time was 78.5 ± 18.6 minutes, intraoperative blood loss was 40.2 ± 15.6 mL, intraoperative flap-freeing time was 14.3 ± 3.8 minutes, and the diameter of the thyroid tumor was 3.8 ± 2.5 cm. Postoperative hospital stay was 3.5 ± 2.0 days. One patient got voice hoarseness and recovered in 3 months. Two patients suffered from transient hypocalcemia and recovered without treatment. No subcutaneous effusion or seroma was observed. No recurrence was found during the 12- to 36-month (mean: 28 months) follow-up. One patient felt chest numbness 3 months after the surgery. Thirty-two patients were very satisfied with the cosmetic appearance and 8 patients were satisfied. The application of straight-line tunnel in transthoracic endoscopic thyroidectomy is a simple, safe, feasible procedure with less trauma, seroma, and skin contraction.