Transaxillary vs. Transsubclavian Gasless endoscopic thyroidectomy approaches for papillary thyroid cancer
Abstract The use of transaxillary and transsubclavian approaches for endoscopic thyroidectomy has increased globally. However, studies examining the comparative outcomes of these procedures are scarce. In this study, we aimed to compare the safety and efficacy of thyroidectomy between the gasless en...
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Nature Portfolio
2025-01-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-024-84683-8 |
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| author | Hongji Wu Meiyu Zhu Chi Ma Rui Yang Yanzhong Gu Shujian Wei Xincheng Liu Haiqing Sun Guibin Zheng Xicheng Song Haitao Zheng |
| author_facet | Hongji Wu Meiyu Zhu Chi Ma Rui Yang Yanzhong Gu Shujian Wei Xincheng Liu Haiqing Sun Guibin Zheng Xicheng Song Haitao Zheng |
| author_sort | Hongji Wu |
| collection | DOAJ |
| description | Abstract The use of transaxillary and transsubclavian approaches for endoscopic thyroidectomy has increased globally. However, studies examining the comparative outcomes of these procedures are scarce. In this study, we aimed to compare the safety and efficacy of thyroidectomy between the gasless endoscopic thyroidectomy transaxillary approach (GETTA) and gasless endoscopic thyroidectomy transsubclavian approach (GETTSA) in patients with papillary thyroid cancer (PTC). Medical records of patients with PTC who underwent GETTA or GETTSA performed by the same surgical team between August 2022 and August 2023 were retrospectively reviewed. Propensity score matching (PSM) was used to mitigate potential selection bias and adjust for baseline clinical characteristic differences. After PSM using 10 covariates, 196 patients (GETTA: 98; GETTSA: 98) were included. In comparison to the GETTSA group, the GETTA group exhibited a longer duration of operation (120.00 [103.75–140.00] vs. 110.00 [90.00–125.00] min, P = 0.001), longer postoperative hospital stays (1.00 [1.00–3.00] vs. 1.00 [1.00–2.00] days, P = 0.008), higher hospitalisation costs (23,973.02 [22,640.80–25,379.80] vs. 23,306.00 [21,968.97–24,070.68] Yuan, P = 0.015), and greater postoperative drainage (60.00 [50.00–70.00] vs. 46.50 [40.00–56.25] mL, P < 0.001). Intraoperative parathyroid autotransplantation and vocal cord paralysis rates were not significantly different between groups. The number of lymph node metastases via central lymph node dissection was not significantly different between groups (0.00 [0.00–1.00] vs. 0.00 [0.00–1.00], P = 0.645). No significant procedural safety or completeness differences were observed between GETTA and GETTSA. GETTA had better cosmetic outcomes. GETTSA had shorter duration of operation durations, shorter hospital stays, lower hospitalisation costs, and lower postoperative drainage, making it a better option for clinical use. |
| format | Article |
| id | doaj-art-6000cd151c05479e856011fb544f69f2 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-6000cd151c05479e856011fb544f69f22025-01-05T12:22:18ZengNature PortfolioScientific Reports2045-23222025-01-0115111010.1038/s41598-024-84683-8Transaxillary vs. Transsubclavian Gasless endoscopic thyroidectomy approaches for papillary thyroid cancerHongji Wu0Meiyu Zhu1Chi Ma2Rui Yang3Yanzhong Gu4Shujian Wei5Xincheng Liu6Haiqing Sun7Guibin Zheng8Xicheng Song9Haitao Zheng10Department of Thyroid Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao UniversityDepartment of Thyroid Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao UniversityDepartment of Thyroid Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao UniversitySchool of Clinical Medicine, Shandong Second Medical UniversityThe Second School of Clinical Medicine, Binzhou Medical UniversityDepartment of Thyroid Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao UniversityDepartment of Thyroid Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao UniversityDepartment of Thyroid Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao UniversityDepartment of Thyroid Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao UniversityDepartment of Otorhinolaryngology, Head and Neck Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao UniversityDepartment of Thyroid Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao UniversityAbstract The use of transaxillary and transsubclavian approaches for endoscopic thyroidectomy has increased globally. However, studies examining the comparative outcomes of these procedures are scarce. In this study, we aimed to compare the safety and efficacy of thyroidectomy between the gasless endoscopic thyroidectomy transaxillary approach (GETTA) and gasless endoscopic thyroidectomy transsubclavian approach (GETTSA) in patients with papillary thyroid cancer (PTC). Medical records of patients with PTC who underwent GETTA or GETTSA performed by the same surgical team between August 2022 and August 2023 were retrospectively reviewed. Propensity score matching (PSM) was used to mitigate potential selection bias and adjust for baseline clinical characteristic differences. After PSM using 10 covariates, 196 patients (GETTA: 98; GETTSA: 98) were included. In comparison to the GETTSA group, the GETTA group exhibited a longer duration of operation (120.00 [103.75–140.00] vs. 110.00 [90.00–125.00] min, P = 0.001), longer postoperative hospital stays (1.00 [1.00–3.00] vs. 1.00 [1.00–2.00] days, P = 0.008), higher hospitalisation costs (23,973.02 [22,640.80–25,379.80] vs. 23,306.00 [21,968.97–24,070.68] Yuan, P = 0.015), and greater postoperative drainage (60.00 [50.00–70.00] vs. 46.50 [40.00–56.25] mL, P < 0.001). Intraoperative parathyroid autotransplantation and vocal cord paralysis rates were not significantly different between groups. The number of lymph node metastases via central lymph node dissection was not significantly different between groups (0.00 [0.00–1.00] vs. 0.00 [0.00–1.00], P = 0.645). No significant procedural safety or completeness differences were observed between GETTA and GETTSA. GETTA had better cosmetic outcomes. GETTSA had shorter duration of operation durations, shorter hospital stays, lower hospitalisation costs, and lower postoperative drainage, making it a better option for clinical use.https://doi.org/10.1038/s41598-024-84683-8Endoscopic thyroidectomyGasless transaxillary approachGasless transsubclavian approachSafetyCentral neck dissection |
| spellingShingle | Hongji Wu Meiyu Zhu Chi Ma Rui Yang Yanzhong Gu Shujian Wei Xincheng Liu Haiqing Sun Guibin Zheng Xicheng Song Haitao Zheng Transaxillary vs. Transsubclavian Gasless endoscopic thyroidectomy approaches for papillary thyroid cancer Scientific Reports Endoscopic thyroidectomy Gasless transaxillary approach Gasless transsubclavian approach Safety Central neck dissection |
| title | Transaxillary vs. Transsubclavian Gasless endoscopic thyroidectomy approaches for papillary thyroid cancer |
| title_full | Transaxillary vs. Transsubclavian Gasless endoscopic thyroidectomy approaches for papillary thyroid cancer |
| title_fullStr | Transaxillary vs. Transsubclavian Gasless endoscopic thyroidectomy approaches for papillary thyroid cancer |
| title_full_unstemmed | Transaxillary vs. Transsubclavian Gasless endoscopic thyroidectomy approaches for papillary thyroid cancer |
| title_short | Transaxillary vs. Transsubclavian Gasless endoscopic thyroidectomy approaches for papillary thyroid cancer |
| title_sort | transaxillary vs transsubclavian gasless endoscopic thyroidectomy approaches for papillary thyroid cancer |
| topic | Endoscopic thyroidectomy Gasless transaxillary approach Gasless transsubclavian approach Safety Central neck dissection |
| url | https://doi.org/10.1038/s41598-024-84683-8 |
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