Abstract: Objective To investigate the short outcome and the learning curve of endoscopic thyroidectomy via areola approach at a single centre for differentiated thyroid carcinoma. Methods A retrospective analysis was made with 100 patients undergoing endoscopic thyroidectomy via areola approach in the treatment of differentiated thyroid carcinoma from November 2015 to May 2017. The consecutive cases were divided into 5 groups as group A, B, C, D and E each 20 cases. Surgical data including the time of procedure such as flap dissection, thyroid resection and lymphadectomy, total operating time, operative blood loss, lymph node harvest, injury to the parathyroid glands, conversion and intraoperative complications, and postoperative data including hospital stay, drainage volume and postoperative complications were compared among 5 groups. Learning curve was analyzed using mathematical model. Results All patients underwent endoscopic thyroidectomy via areola approach without conversions. There was statistical difference of total operating time and the time of procedures among groups (P<0.001). Group A had 3 cases with intraoperative complications more than other groups (P=0.035). Groups A had 12 cases with subcutaneous ecchymosis more than other groups (P<0.001). Analysis of multivariate learning curve showed that the learning phase included 31 patients. Conclusions It was shown that endoscopic thyroidectomy via areola approach for differentiated thyroid carcinoma has longer learning phase. Effective and standard manipulation in view of special characteristics would make endoscopic thyroidectomy via areola approach safe and feasible.

Key words: Endoscopy, Thyroidectomy, Areola approach, Thyroid neoplasm, Learning curve