Endoscopic Thyroidectomy Versus Open Thyroidectomy for Papillary Thyroid Carcinoma

Endoscopic Thyroidectomy Using Gasless Unilateral Transaxillary Approach Versus Conventional Open Thyroidectomy for Papillary Thyroid Cancer: a Prospective, Multicenter, Randomized Controlled Clinical Trial

Recently, endoscopic thyroidectomy using gasless unilateral transaxillary approach has been proven feasible and safe in several Chinese medical centers. This study is aimed to compare multi-institutional Chinese outcomes of endoscopic thyroidectomy using gasless unilateral transaxillary approach and conventional open surgery.

Most patients with thyroid tumors are effectively treated surgically by practitioners experienced in the techniques of thyroidectomy. Many patients, especially women, undergoing thyroid surgery are concerned about the postoperative cosmetic appearance of the neck. Endoscopic thyroidectomy using gasless unilateral transaxillary approach which can hide the operative scar was associated with a higher degree of patient cosmetic satisfaction. Recently, endoscopic thyroidectomy using gasless unilateral transaxillary approach has been proven feasible and safe in several Chinese medical centers. In this study, we designed a prospective study comparing multi-institutional Chinese outcomes of endoscopic thyroidectomy using gasless unilateral transaxillary approach and conventional open surgery.

Inclusion Criteria:

• Age ≥ 18 years;
• The pathological type is papillary thyroid carcinoma;
• Tumor diameter <2 cm；
• No extraglandular invasion, or minimal extrathyroidal extension invading only anterior thyroid capsule or sternothyoid muscle；
• cN0 or cN+ without fusion and fixation of metastatic lymph nodes；
• no obvious contraindication for thyroidectomy ;
• Good comply with the research visit plan and other program requirements;
• Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria:

• patients with severe systemic diseases who can not tolerate general anesthesia or routine surgical posture;
• previous history of neck surgery, radiotherapy or thermal ablation;
• hyperthyroidism and substernal goiter;
• dedifferentiated thyroid carcinoma；
• accompanied with severe thyroiditis.