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Background To evaluate the feasibility and safety of endoscopicthyroidectomy for early stage papillary thyroid cancer (T1N0M0), we adapted endoscopicthyroidectomy via anterior chest approach. Methods From April 2005 to December 2010,Ninety five patients with early stage papillary thyroid cancer underwent minimally invasive endoscopic thyroidectomy via anterior chest approach. The clinical andpathologic characteristics of patients, the type of operation, operative time, length ofpostoperative hospital stay, and postoperative complications were analyzedretrospectively. Results All 95 operations were successfully performed endoscopically.There was no conversion to open surgery. The tumor size was 0.96 ± 0.7 cm. Theoperation type was unilateral lobectomy (31 cases), unilateral subtotal thyroidectomy(5cases), ipsilateral total and contralateral subtotal thyroidectomy (44 cases), andbilateral total thyroidectomy (15 cases). Central compartment node dissection was carriedout in 35 cases with the tumor diameter less than 1.0 cm and 28 cases with the tumordiameter at the range of 1.0-2.0 cm. The operating time was 99 ±17 min, bleedingvolume was 18±12 ml, and the length of post-operative hospital stay was 3±1 days,respectively. Three patients showed temporary paresis of the recurrent laryngeal nerve(RLN), and recovered within 1 to 2 months after the surgery. One patient showedpermanent paralysis of the RLN. 2 patients showed hypoparathyroidism. No patientshowed post-operative seroma and tracheal injury. There were no injuries to the superiorlaryngeal nerve. No further complications, such as irritating cough, tetany, andemphysema developed after the operation. Because of the anterior chest wall approach,none of the patients had a surgical scar on the neck and all were satisfied with thecosmetic effect. All patients were disease free and the follow-up was 16 to 84 months(average 48.4±17.2 months). Conclusions Our early experience indicates that minimallyinvasive endoscopic thyroid surgery of early stage papillary thyroid cancer throughanterior chest approach is a feasible and safe method. This technique had better cosmeticresults and the long-term effect of this technique need more evaluation.