Lateral Collar Approach for Thyroid Lobectomy of Papillary Thyroid Carcinoma

Since the 2015 American Thyroid Association Guidelines were released, less total thyroidectomy has been accepted in more patients with differentiated thyroid cancer. The traditional Kocher incision makes it easy to preserve the surrounding structures by securing an adequate surgical field of view, leaving a noticeable postoperative incision scar. Minimally invasive or remote-access extra-cervical approaches have been developed to improve the cosmetic problem. However, considering the high cost, prolonged operation time, and potential morbidity, it isn’t easy to use the alternative-site approaches. A top or necklace may cover an incision scar if the low collar incision is moved to the lateral neck. Therefore, this study evaluated the outcomes of thyroid lobectomy through a lateral collar incision. Seventy-five patients with papillary thyroid carcinoma (PTC) undergoing the lateral collar approach were compared with the non-randomized control of 75 PTC patients undergoing the Kocher incision. The surgical time, bleeding amount, complications, voice, and swallowing function were comparable between this lateral collar and conventional approaches. The cosmetic satisfaction on incision scar was higher than in the traditional incision. The lateral collar approach may be a good alternative for the thyroid lobectomy of PTC. Therefore, this article introduces the procedures and applications of the lateral collar approach as a technical note.