A Retrospective Meta-Analysis Study of Trans-axillary Hemithyroidectomy Versus Conventional Hemithyroidectomy: Surgical Efficacy and Safety | ||
| Ain Shams Journal of Surgery | ||
| Volume 18, Issue 4, October 2025, Pages 289-299 PDF (960.61 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/asjs.2025.397277.1214 | ||
| Authors | ||
| Moatasum Hussein Hamed* 1; Sameh Abdullah2; Alaa Mohamed El-Erian1; Ahmed Nabil El-Hoofy2; Mohamed Ahmed El-Shimy2; Mohamed Samir El-Sebaie3 | ||
| 1Department of General & Endocrine Surgery, National Institute of Endocrinology, Cairo, Egypt | ||
| 2Department of General & Bariatric Surgery, Ain Shams University, Cairo, Egypt | ||
| 3Department of General & Endocrine Surgery, Ain Shams University, Cairo, Egypt | ||
| Abstract | ||
| Introduction: Thyroid disease is common among women and increasingly prevalent globally. Surgery is often required, with open thyroidectomy being the gold standard. However, cosmetic dissatisfaction from cervical scars has led to interest in endoscopic alternatives. Since Gagner’s first endoscopic procedure, non-cervical techniques like trans-axillary thyroidectomy have gained attention for hiding scars and improving quality of life. Aim of work: We aimed to compare trans-axillary hemithyroidectomy and traditional open surgical approach from the available literature regarding operative difficulties, feasibility, complication (intra -and post-operative), post-operative pain and cosmesis. Patients and methods: This systematic review and meta-analysis has been performed on seven papers in accordance with the Cochrane Collaboration standards and adhered to the PRISMA declaration (Preferred Reporting Items for Systematic Reviews and Meta-analyses). Results: The endoscopic thyroidectomy group had significantly lower blood loss (MD = 1.29, 95% CI [0.32, 2.25], p = 0.009) compared to the open group, while the open group had a significantly shorter operative time (MD = 37.6, 95% CI [42.77, 32.44], p < 0.00001). Insignificant variations have been detected in pain following surgery, hospital stay, post-operative hematoma, or vocal cord paralysis. However, endoscopic thyroidectomy was superior in cosmetic satisfaction (MD = 7.05, 95% CI [13.23, 0.88], p = 0.03), despite of high heterogeneity (I² = 98%). Heterogeneity was low for most outcomes but significant for operative time (I² = 82%) and hospital stay (I² = 68%). Conclusion: Trans-axillary endoscopic thyroidectomy is a safe and effective alternative with superior cosmetic outcomes. Technique selection should consider clinical factors and patient preferences. | ||
| Keywords | ||
| Trans-axillary hemithyroidectomy; conventional hemithyroidectomy; endoscopic thyroidectomy; surgical efficacy; safety | ||
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