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ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Thyroid Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1448672
This article is part of the Research Topic Advances in precision medicine in the management of thyroid nodules and thyroid cancer View all 38 articles
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Introduction: Endoscopic thyroid surgery, which relocates the incision to a less visible area of the body, offers significant postoperative cosmetic benefits and has been widely used in the treatment of thyroid microcarcinomas. This study conducts a retrospective case analysis and questionnaire survey to provide clinical reference by statistically analyzing the development of endoscopic techniques in China over the past five years. Materials and Methods: This study included cases of thyroid microcarcinoma surgeries performed in our hospital from January 2018 to March 2020. Postoperative follow-up was conducted using the THYCA-QoL questionnaire. A network questionnaire survey was carried out through the Chinese Society of Oncoplastic Endocrine Surgeons targeting its members and other institutions performing endoscopic thyroid surgeries. The data was analyzed to obtain relevant results. Results: The complications were comparable between the endoscopic and open surgery groups. The incidence of neck discomfort was higher in the open surgery group compared to the endoscopic group (21.92% vs. 13.38%). Scar formation was also more noticeable in the open surgery group (23.74% vs. 17.2%). The local recurrence rates were similar between the two groups (1.27% vs. 1.37%). Over 85% of the surveyed institutions reported endoscopic thyroid surgery via trans-breast approach, while the trans-axillary approach showed the fastest growth over the past five years. The most frequently questioned issues regarding the trans-breast and trans-axillary approaches were the completeness of central lymph node dissection (with 66.78% and 40.46% of respondents, respectively, considering the lymph node dissection to be incomplete). Furthermore, about 20%-30% of the surveyed institutions believed that endoscopic surgery was more traumatic and associated with a higher incidence of postthyroidectomy syndrome (PTS). Conclusion: For papillary thyroid microcarcinoma, endoscopic surgery demonstrates comparable efficacy to traditional open surgery, with no significant differences observed in 5-year recurrence and survival rates during follow-up. However, the safety and reliability of various endoscopic approaches for thyroid cancer surgery remain questionable, particularly regarding the thoroughness of central compartment lymph node dissection, as indicated by surveys on the implementation of endoscopic thyroid surgery over five consecutive years. More long-term follow-up data are required to validate these outcomes.
Keywords: Thyroid microcarcinoma, Trans-breast, Endoscopic thyroid surgery, Trans-axillary, Trans-oral
Received: 13 Jun 2024; Accepted: 27 Mar 2025.
Copyright: © 2025 Liang and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yinghui Liang, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
Shuangta Xu, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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