Abstract:

Objective   To explore the effect of endoscopic near total thyroidectomy followed by radioiodine remnant ablation (RRA) in differentiated thyroid carcinoma. Methods   Between January 2008 and March 2011, 27 cases of differentiated thyroid carcinoma, with the diameter of smaller than 4cm, without obvious lymph nodal metastases and extraglandular invasion, underwent endoscopic operation followed by RRA. Results   The endoscopic near total thyroidectomy was finished in all of 27 patients. Among them, the chest and breast approach was used in 17 cases, and the axillary and breast approach was used in 10 cases. The operation time was 60-180min, with the mean time of 105min. Blood loss was 10~80mL (mean, 20mL). Post-operative hospital stays were 4~8 days (mean, 5.6 days). Temporality injury of recurrent laryngeal nerve occurred in 2 cases and healed after 3 months. No recurrence or metastases were found in all of patients after a follow-up of 4~38 months (mean, 12 months). TG stimulated by TSH was more than 10ng/mL in 2 cases, while 0~7.74ng/mL (mean, 2.36ng/mL) in other cases. All patients were satisfied with the neck appearance. Conclusions   Considering the high safety, radical efficacy and favorable cosmetic outcome, endoscopic near total thyroidectomy followed by RRA is suitable for those patients with lowrisk differentiated thyroid carcinoma absenting obvious nodal metastases.

Key words:  Differentiated thyroid carcinoma; Endoscope; Near total thyroidectomy; Radioiodine remnant ablation