Assessment of surgical completeness in unilateral axillo-breast approach endoscopic thyroidectomy compared with bilateral axillo-breast approach and open thyroidectomy using radioactive iodine whole body scan

1878 Objectives To evaluate the surgical completeness of the unilateral axillo-breast approach endoscopic thyroidectomy (UABA), we compared UABA, bilateral axillo-breast approach (BABA) and open thyroidectomy (OT) by means of the radioactive iodine (RAI) uptake of remnant thyroid. Methods Fifty nine patients with differentiated thyroid cancer were enrolled from July 2010 to March 2012 and they underwent total thyroidectomy and RAI ablation. Of 59 patients, 17 patients underwent UABA, 24 patients underwent BABA and the other 18 patients underwent OT. Stimulated serum thyroglobulin (Tg) levels on the day of RAI administration and the RAI activities of remnant thyroid tissue calculated by the neck-to-skull uptake ratio (NSR) on the whole body scan 2 days after RAI administration were obtained. The differences in TG and NSR according to the surgical methods were compared by using Kruskal-Wallis test. Results The median values of NSR of patients who underwent UABA, BABA, and OT were 12.9 (1.4-57.7), 10.1 (3.0-49.1), 6.0 (2.2-33.6), respectively (p = 0.259). The median values of Tg levels of patients who underwent UABA, BABA, and OT were 2.4 (0.7-14.2), 0.7 (0.7-29.3), 0.7 (0.7-16.9), respectively (p = 0.091). There were no significant differences in regards of the NSR, the stimulated Tg level, between UABA, BABA and OT groups. Also there was no significant difference between NSR of UABA and OT (p = 0.068). Conclusions The completeness of the surgical removal by UABA was comparable with that of BABA or OT. The UABA might give a safe option for patients with low-risk thyroid cancer.