Techniques on endoscopic resection of large thyroid nodules by areola approach

Abstract Purpose: Endoscopic thyroidectomy via areola approach (ETA) is a safe and efficient procedure in treating thyroid nodule. However, reports on large nodules(>6cm) resection via ETA are rare. Methods: Between February 2021 and October 2021, five continuous female patients with thyroid nodules larger than 6cm underwent endoscopic thyroidectomy via ETA. The surgical techniques were elaborated and major clinical characteristics including nodule size, operation time and blood loss were analyzed. Results: All the nodules were resected successfully via ETA. All patients were female with an average age of 33 ± 9 yrs. The average largest diameter of the nodules was 6.6±0.4 cm. All patients underwent thyroid lobectomy. The average operation time was 122 ± 8 min . The average blood lost was 17± 4 ml. One patient had transient recurrent laryngeal nerve (RLN) palsy. No patient underwent a conversion to open surgery. All patients were satisfied with the cosmetic Result. Conclusion: ETA is a safe and feasible option for patients with thyroid nodule larger than 6cm. With cautious selection, large nodules could be safely and efficiently resected via ETA.