Sternohyoid and sternothyroid approach in reoperations for recurrent thyroid cancer: a comparative analysis

Background: Reoperation for recurrent thyroid cancer (TC) presents unique challenges, necessitating exploration of optimal surgical approaches for improved outcomes. Therefore, this study aimed to compare the lateral intermuscular approach (LIA) between the sternohyoid and sternothyroid muscles with the standard cervical white line approach (SCWLA) in reoperations for recurrent TC. Methods: In the single-center retrospective cohort study, a total of 102 patients with recurrent TC undergoing reoperation were included and, according to the intraoperatively selected surgical approach, were divided into a SCWLA group (n=51) and a LIA between the sternohyoid and sternothyroid muscles group (n=51). Thyroid exposure, surgical parameters, and postoperative complications were evaluated. Results: The LIA group demonstrated significantly better thyroid exposure across multiple anatomical regions, providing a wider surgical field, clearer visualization of key structures, and facilitating safer dissection, along with shorter operative and hospitalization period and reduced intraoperative blood loss compared with the SCWLA group. Postoperative complications were also less frequent in the LIA group. Conclusions: Implementing the sternohyoid and sternothyroid LIA in reoperations for recurrent TC offers improved local structure exposure, decreased trauma, faster recovery, and reduced postoperative complications.