Abstract
Background
Since the first description of the minimally invasive totally gasless video-assisted thyroidectomy (MIVAT) technique in 1998, relatively few studies have evaluated the outcome of this procedure. The authors review their experiences based on a prospective randomized trial comparing the potential advantages of MIVAT over conventional thyroidectomy.
Methods
Patients undergoing surgery for either thyroid nodule or diffuse thyroid disease with hyperthyroidism were randomly selected for either MIVAT or conventional thyroidectomy. The exclusion criteria specified nodules larger than 35 mm, thyroid lobe volume greater than 20 ml, thyroiditis, and previous neck irradiation or surgery. Operative time, postoperative complications, and cosmetic results were evaluated using both a verbal response scale and a numeric scale.
Results
Both the MIVAT group and the conventional thyroidectomy group included 15 patients. No significant differences were noted between the two groups in terms of age, sex, or indication for operation. The mean operative times were 65.5 ± 18 min. for MIVAT and 43.3 ± 14 min. for conventional thyroidectomy (P = 0.001). No postoperative complications were detected in either group. The cosmetic results, evaluated by both verbal response and numeric scales, were respectively as follows: MIVAT (3.7 ± 0.2 and 7.9 ± 1.2) and conventional thyroidectomy (2.3 ± 0.7 and 4.9 ± 1.3). The differences significantly favored MIVAT (P = 0.028 and P = 0.015, respectively) despite the small number of patients enrolled in this study, and consequently, its limited statistical power.
Conclusion
Although the complications are comparable between the two approaches, conventional thyroidectomy involves less operative time. However, MIVAT offers distinct advantages to selected patients in terms of very good to exellent cosmetic results and reduced postoperative distress.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Huscher CS, Recher A, Napolitano G, Chiodini S (1997) Endoscopic right thyroid lobectomy. Surg Endosc 11:877
Yeung GH (1998) Endoscopic surgery of the neck: a new frontier. Surg Laparosc Endosc 8:227–232
Miccoli P, Berti P, Conte M, Bendinelli C, Marcocci C (1999) Minimally invasive surgery for small thyroid nodules: preliminary report. J Endocrinol Invest 22:849–851
Shimazu K, Akira S, Jasmi AY, Kitamura Y, Kitagawa W, Akasu H (1999) Video-assisted neck surgery: endoscopic resection of thyroid tumors with very minimal neck wound. J Am Coll Surg 188:697–703
Kapischke M, Bley K, Deltz E (2003) Minimally invasive video-assisted thyroid resection (MIVAT): a well-accepted operative procedure. Zentralbl Chir 128:652–655
Chan CP, Yang LH, Chang HC, Chen YL, Chen ST, Kuo SJ, Tsai PC (2003) An easier technique for minimally invasive video-assisted thyroidectomy. Int Surg 88:109–113
Miccoli P, Bellantone R, Mourad M, Walz M, Raffaelli M, Berti P (2002) Minimally invasive video-assisted thyroidectomy: multi-institutional experience. World J Surg 26:972–975
Miccoli P, Berti P, Raffaelli M, Materazzi G, Baldacci S, Rossi G (2002) Comparison between minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study. Surgery 130:1039–1043
Inabnet WB, Jacob BP, Gagner M (2003) Minimally invasive endoscopic thyroidectomy by a cervical approach. Surg Endosc 17:1808–1811
Shimazu K, Shiba E, Tamaki Y, Takiguchi S, Taniguchi E, Ohashi S, Noguchi S (2003) Endoscopic thyroid surgery through the axillo-bilateral-breast approach. Surg Laparosc Endosc Percutan Tech 13:196–201
Park YL, Han WK, Bae WG (2003) 100 cases of endoscopic thyroidectomy: breast approach. Surg Laparosc Endosc Percutan Tech 13:20–25
Gagner M, Inabnet WB (2001) Endoscopic thyroidectomy for solitary thyroid nodules. Thyroid 11:161–163
Manolidis S, Takashima M, Kirby M, Scarlett M (2001) Thyroid surgery: a comparison of outcomes between experts and surgeons in training. Otolaryngol Head Neck Surg 125:30–33
Lo Gerfo P (1998) Local/regional anesthesia for thyroidectomy: evaluation as an outpatient procedure. Surgery 124:975–979
Bellantone R, Lombardi PC, Raffaelli M, Boscherini M, De Crea C, Traini E (2002) Video-assisted thyroidectomy. J Am Coll Surg 194:610–614
Ikeda Y, Takami H, Sasaki Y, Takayama J, Niimi M, Kan S (2003) Clinical benefits in endoscopic thyroidectomy by the axillary approach. J Am Coll Surg 196:189–195
Miccoli P, Berti P, Raffaelli M, Materazzi G, Conte M, Galleri D (2002) Impact of harmonic scalpel on operative time during video-assisted thyroidectomy. Surg Endosc 16:663–666
Lombardi CP, Raffaelli M, Modesti C, Boscherini M, Bellantone R (2004) Video-assisted thyroidectomy under local anesthesia. Am J Surg 187:515–518
Dralle H, Lorenz K, Nguyen-Thanh P (1999) Minimally invasive video-assisted parathyroidectomy: selective approach to localised single gland adenoma. Langenbecks Arch Surg 384:556–562
Sackett WR, Barraclough B, Reeve TS, Delbridge LW (2002) Worldwide trends in the surgical treatment of primary hyperparathyroidism in the era of minimally invasive. Parathyroidectomy 137:1055–1059
Miccoli P, Bendinelli C, Berti P, Vignali E, Pinchera A, Marcocci C (1999) Video-assisted versus conventional parathyroidectomy in primary hyperparathyroidism: a prospective randomized study. Surgery 126:1117–1122
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gal, I., Solymosi, T., Szabo, Z. et al. Minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study. Surg Endosc 22, 2445–2449 (2008). https://doi.org/10.1007/s00464-008-9806-2
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-008-9806-2