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Objective To discuss the feasibility of total endoscopic thyroidectomy on papillary thyroid microcarcinoma (PTMC) on the basis of the summary of benign thyroid diseases. Methods We summarized and analyzed the feasibility and experience of total endoscopic thyroidectomy of PTMC based on the retrospective analysis of the clinical data of 60 patients with benign thyroid diseases and 14 PTMC patients underwent total endoscopic surgery. Results In regard to the endoscopic thyroidectomy of benign thyroid diseases, the average size of the nodules was (2.79±0.66) cm and the average operation time was (162.77±32.39) min. As for the 14 cases of endoscopic thyroidectomy of PTMC, all patients undergone unilateral lobe with isthmus resection and ipsilateral lymph node dissection in the central region. The average size of the nodules was (0.65±0.26) cm and the average operation time was (200.77±24.37) min. The number of dissected central lymph nodes was (5.73±2.86). The median amount of intraoperative bleeding was 17ml. Unilateral lobe in 14 cases were completely removed. Among them, four cases occurred postoperative transient asymptomatic hypocalcemia, and no hoarseness. Conclusion Based on the experience of total endoscopic thyroidectomy of benign thyroid disease, it is safe and feasible to select PTMC for endoscopic surgery. Auxiliary techniques, such as carbon nanoparticles, neural monitoring, etc., could be used to fully expose the vision and improve the safety of operation.

Background: Information regarding the implementation of sentinel lymph node biopsy (SLNB) in invasive lobular carcinoma (ILC) is scarce, and whether ILC patients with 1-2 positive sentinel lymph nodes (SLNs) can be omitted from axillary lymph node dissection (ALND) remains controversial. This study aimed to compare involvement of SLNs and non-SLNs between patients with invasive ductal carcinoma (IDC) and ILC., Methods: We retrospectively collected the clinical and pathological data of invasive breast cancer patients from 37 medical centers in China from January 2018 to December 2018. The number of resected SLNs, positive rate of SLNs, and non-SLNs metastasis were compared between patients with IDC and ILC., Results: A total of 6,922 patients were included, comprising 6,650 with IDC (96.1%) and 272 with ILC (3.9%). No difference was observed in the number of resected SLNs between patients with IDC and ILC (IDC: 4.0±1.9 vs. ILC: 3.9±1.6, P=0.352). The positive rate of SLNs was significantly higher in patients with IDC than that in patients with ILC (19.3% in IDC vs . 12.9% in ILC, P=0.008). The difference in positive rate of SLNs between IDC and ILC was mainly attributed to macro-metastasis. For patients with positive SLNs who received ALND, and those with 1-2 positive SLNs, the metastatic rate of non-SLNs in the ILC group was higher than that in the IDC group (for patients with positive SLNs: 50.0% in ILC vs . 39.9% in IDC, P=0.317; for patients with 1-2 positive SLNs: 45.4% in ILC vs . 34.8% in IDC, P=0.366), but the differences were not statistically significant., Conclusions: Patients with ILC had similar number of resected SLNs and lower positive rate of SLNs compared to those with IDC. In participants with 1-2 positive SLNs, the ILC group had an increased tendency for non-SLNs metastasis compared with the IDC group. Surgeons may need to be more cautious about omitting ALND for ILC patients with 1-2 positive SLNs., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://dx.doi.org/10.21037/atm-21-5169). The authors have no conflicts of interest to declare., (2021 Annals of Translational Medicine. All rights reserved.)