Mini-incision Thyroidectomy in Contemporary Practice: Safety, Efficiency, and Cosmetic Outcomes from a Large Consecutive Cohort

Abstract Background Open thyroidectomy remains the standard procedure for most thyroid diseases, but may result in a visible cervical scar that affects patient satisfaction. Mini-incision thyroidectomy (MIT) is a reduced-access modification of open surgery designed to limit incision length while preserving conventional anatomy and operative principles. Evidence supporting its routine use remains limited. Methods We conducted a retrospective cohort study of all consecutive patients who underwent MIT at a high-volume endocrine surgery unit between December 2014 and December 2019. Demographic data, ultrasound findings, operative details, incision length, postoperative complications, and patient-reported cosmetic satisfaction were analyzed. All procedures were performed by the same experienced team using a standardized, non-endoscopic technique. Results A total of 209 patients were included (79.9% female; mean age 39.6 years). Mean thyroid volume was 35.1 mL, and mean dominant nodule size was 2.56 cm. MIT was completed in all cases through a short cervical incision (mean 2.81 cm) without conversion. Mean operative time was 59.4 minutes, with minimal blood loss. Transient hypocalcemia occurred in 9.6% of patients and transient recurrent laryngeal nerve palsy in 7.7%. One patient (0.5%) developed permanent hypoparathyroidism, with no permanent nerve injury. Reoperation for bleeding was required in 1.0% of cases. Cosmetic dissatisfaction was reported by 4.8% of patients. Conclusions MIT is a safe and feasible reduced-access approach for selected thyroid diseases, including low-risk malignancies. It achieves outcomes comparable to conventional thyroidectomy while providing high patient satisfaction with scar appearance, without the need for endoscopic or robotic assistance.