Clinical comparison of total endoscopy and open thyroidectomy for cT1N0 thyroid papillary carcinoma

Objective To explore the feasibility of totally endoscopic thyroidectomy (TET) for thyroid papillary carcinoma in cT1N0 stage. Methods Clinical data of 287 patients with primary cT1N0 thyroid papillary cancer underwent thyroidectomy in our hospital from March 2016 to June 2018 were collected and retrospectively analyzed, including 145 patients undergoing TET (TET group) and 142 patients by open thyroidectomy (OT group). The intraoperative conditions, complications, recurrence and cosmetic effect were compared between the 2 groups. Results There were no significant differences in the general data of the patients in the TET group and OT group, including mean age (P=0.283), sex ratio (P=0.344), tumor size (P=0.265) and tumor distribution (P=0.872). In terms of surgical effects, no significant differences were observed in the numbers of central neck lymph node dissections (CNLN) (P=0.847) and metastatic lymph nodes (P=0.839) between the 2 groups for the patients with lateral lobectomy and lateral central neck dissection. The TET group had significantly smaller volume of intraoperative bleeding (P 0.05). No hemorrhagic subcutaneous fluid or wound infection occurred in the TET group. The TET group had significantly better cosmetic effect than the OT group (P < 0.001). The patients were followed up for 6 to 30 months, and no recurrence was observed. Conclusion TET treatment is safe and feasible for cT1N0 thyroid papillary cancer. TET treatment might be an optional approach for the patients with cosmetic demand