Efficacy and safety of gasless transaxillary endoscopic surgery for patients with benign thyroid nodules

REN Guoying; LI Ning; ZHANG Lingran; WANG Dechao; ZHANG Zhimei; AN Xinshan

doi:10.3969/j.issn.1002-3429.2026.06.016

Abstract：Objective To investigate the impact of gasless transaxillary endoscopic surgery on the cosmetic outcomes and complications for thyroid nodules.Methods A total of 94 patients with thyroid nodules who underwent surgery from January 2023 to October 2024 were selected.Among them,50 patients received gasless transaxillary complete endoscopic thyroid surgery,and 44 patients received conventional laparoscopic surgery.Propensity score matching(PSM)was performed based on the baseline data of the two groups,resulting in 42 matched pairs,and they were assigned to the gasless surgery group and the traditional group.The surgical indicators,thyroid function,cosmetic outcomes,and postoperative complications of the two groups were compared.Results The length of the surgical incision and the length of hospitalization were shorter,the duration of operation was longer and the intraoperative blood loss was less in gasless surgery group,as compared with those in the traditional group(P<0.05).There was no significant difference in thyroid function between the two groups before and at 1 month after surgery(P>0.05).At six months and one year after surgery,the Vancouver Scar Scale(VSS),Patient Scar Self-Assessment Scale(PSAS),and Observer Scar Assessment Scale(OSAS)scores of the patients in the gasless surgery group were all lower than those in the traditional group(P<0.01).The complication rate of the patients in the gasless surgery group[2.38%(1/42)]was lower than that of the traditional group[23.81%(10/42)](P<0.05).Conclusion Gasless transaxillary endoscopic surgery can reduce the intraoperative blood loss in patients with thyroid nodules,accelerate postoperative recovery,and have minimal impact on the patient's thyroid function,with better cosmetic outcomes,and a low incidence of complications.