‌Refined supraclavicular approach in unilateral thyroid surgery: balancing minimal invasion with oncologic radicality‌.

Objective: This study introduces a modified thyroidectomy with an oblique supraclavicular incision through the strap intermuscular space.The research evaluates this new approach's feasibility, safety, and effectiveness against the other two, focusing on lessening surgical trauma and bettering cosmetic results.

Methods: Analysis was conducted on clinical data from 508 patients who underwent unilateral thyroid cancer surgery at the First Affiliated Hospital of Ningbo University from December 2023 to December 2024. Patients were classified into three groups: endoscopic, supraclavicular, and Kocher. Comparative assessment between these groups was based on clinical characteristics, perioperative parameters, postoperative complications, sensory outcomes, pain severity, scar awareness, and satisfaction with the surgical incision.

Results: The three patient groups had similar clinical profiles. The group with the supraclavicular approach had shorter operation times and reduced drainage compared to the other groups, with a smaller incision than the Kocher approach (P < 0.05). However, they reported comparable levels of pain, success rates in lymph node dissection, and length of hospital stays (P > 0.05). Following surgery, the supraclavicular group exhibited superior neck function (P < 0.05) and better preservation of laryngeal nerves than the endoscopic group. Moreover, the supraclavicular approach demonstrated a relatively smaller and less invasive neck flap separation area. Over time, patients from the supraclavicular group expressed higher satisfaction with their scars compared to those in the Kocher group.

Conclusion: Our data validate the oblique supraclavicular approach through sternohyoid-sternothyroid planes as a technically feasible alternative to conventional thyroidectomy, offering comparable oncological outcomes with enhanced cosmetic benefits.