Comparison of endoscopic and open surgical approaches in reoperative thyroid surgery

To investigate the feasibility and efficacy of endoscopic surgery in reoperative thyroid surgery. A retrospective analysis was conducted on the clinical data of 94 patients who underwent reoperative thyroid surgery at our hospital and the First Affiliated Hospital of Jinan University from January 2018 to June 2023. Among them, 41 patients underwent endoscopic surgery via a complete areola approach, and 53 patients underwent open surgery. The two groups were compared in terms of operative time, intraoperative blood loss, drainage volume, drainage time, hospital stay, pain scores, cosmetic satisfaction, and complications. Compared with the open surgery group, the endoscopic group had less intraoperative blood loss [(5.9 ± 2.3) ml vs. (16.5 ± 9.4) ml, t = -7.90, P = 0.000] and higher postoperative cosmetic satisfaction [(2.9 ± 0.4) points vs. (1.8 ± 0.8) points, t = -7.802, P = 0.000]. The two groups were followed up for (31.4 ± 8.5) months and (32.5 ± 10.9) months, respectively ( t = 0.526, P = 0.600). There were no significant differences in operative time, drainage volume, drainage time, hospital stay, or pain scores between the two groups [(112.1 ± 24.3) min vs. (120.9 ± 26.0) min, t = -1.680, P = 0.096; (91.8 ± 16.6) ml vs. (97.4 ± 17.0) ml, t = -1.610, P = 0.111; (69.2 ± 19.0) h vs. (75.8 ± 20.4) h, t = -1.604, P = 0.112; (5.7 ± 1.8) d vs. (6.0 ± 1.7) d, t = -0.869, P = 0.387; (3.8 ± 2.2) points vs. (4.4 ± 2.0) points, t = -1.352, P = 0.180]. Endoscopic surgery is a safe and effective approach for reoperative thyroid surgery. Compared with open surgery, it offers better cosmetic outcomes and reduces intraoperative blood loss.