Axillo-breast versus bilateral axillo-breast endoscopic thyroidectomy: a randomized quality-of-life study
In brief
Axillo-breast thyroidectomy cuts early neck numbness and boosts vitality compared with bilateral approach
In a randomized trial of 64 patients, the single-incision axillo-breast technique led to less neck and chest numbness and higher vitality scores at two weeks, with advantages fading by six weeks. Overall quality-of-life scores and complication rates were similar between the two endoscopic methods, suggesting both are safe but the simpler approach offers a brief early recovery benefit.
- Journal
- Surgical endoscopy (Q1)
- Published
- 28 July 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Shahidul Haq Dar, Kamal Kataria, Anita Dhar, Thirugnanasambandam Nelson, Uttam Kumar Thakur, Yashwant Rathore, et al.
- PMID
- 42521830
- DOI
- 10.1007/s00464-026-13199-1
Why clinicians should know about it
- Picked for Breast and Endocrine Surgery (top studies of the week, 18 October 2026): Randomized trial comparing ABA vs BABA thyroidectomy
Abstract
BACKGROUND: Thyroid lesions, both benign and malignant, are common worldwide. Although conventional open thyroidectomy remains effective, the visible cervical scar is a cosmetic concern, particularly for younger patients. Endoscopic thyroidectomy techniques such as the Axillo-Breast Approach (ABA) and Bilateral Axillo-Breast Approach (BABA) were developed to overcome this limitation. This study aimed to compare these two approaches with respect to postoperative health-related quality of life (QOL). METHODS: In this randomized controlled trial, 64 adult patients (> 18 years) with Bethesda category III or lower cytology and thyroid gland volume < 40 mL were randomized to undergo endoscopic hemithyroidectomy via either ABA or BABA. The primary outcome was postoperative QOL assessed using the Short Form-36 (SF-36) questionnaire and a thyroid-specific questionnaire at 2, 6, and 12 weeks after surgery. Secondary outcomes included postoperative complications, duration of hospital stay, pain scores, conversion to open surgery, and ease of performing the procedure. RESULTS: At 6 weeks, significantly higher scores were observed in the ABA group for Vitality (p = 0.045) and Social Function (p = 0.027), whereas no significant differences were identified in the remaining SF-36 domains. At 2 weeks, ABA showed a trend toward higher general health and vitality scores. On thyroid-specific assessment at 2 weeks, ABA was associated with significantly less neck and chest numbness (p = 0.0028) and better neck mobility (p = 0.004) compared to BABA; these differences resolved by 6-12 weeks. Minor complications such as subcutaneous emphysema and ecchymosis were self-limiting. Pain scores, operative difficulty, and hospital stay were similar between groups. CONCLUSIONS: Both ABA and BABA endoscopic hemithyroidectomy techniques were safe. No statistically significant differences were observed in most quality-of-life outcomes between the two approaches. ABA provided a short-term advantage in reducing early postoperative neck numbness and movement restriction, although these differences resolved during follow-up.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.