Clinical Benefits of Minimally Invasive Techniques in Thyroid Surgery |
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Authors: | Giuliano Perigli Camillo Cortesini Etleva Qirici Daniele Boni Fabio Cianchi |
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Institution: | (1) Department of General Surgery, Medical School, University of Florence, Viale Morgagni 85, 50134 Florence, Italy |
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Abstract: | Background Recently there has been a strong impetus to develop minimally invasive techniques in endocrine neck surgery. This study was
designed to investigate the potential benefits of two minimally invasive thyroidectomy procedures, namely video-assisted and
open minimal-incision thyroidectomy (VAT and MIT, respectively) when compared with conventional thyroidectomy.
Methods Between May 2000 and June 2006, a prospective, nonrandomized study was performed on 957 consecutive patients undergoing thyroid
surgery. Fifty-six (5.8%) patients underwent VAT, 214 (22.4%) underwent MIT, and 687 (71.8%) underwent a conventional procedure.
Results Patients were selected for VAT when total thyroid volume was ≤30 ml and for MIT when total thyroid volume was >30 but ≤80
ml as determined by ultrasonography. The length of the central neck skin incision was 1.5–2 cm for VAT, 2.5–3.5 cm for MIT,
and 6–10 cm for the conventional operation. The incidence of definitive hypoparathyroidism or recurrent laryngeal palsy after
VAT or MIT was comparable with that occurring after conventional treatment. Patients having VAT or MIT experienced significantly
less postoperative pain than patients undergoing conventional treatment. Less pain was also registered in the VAT patient
cohort when compared with the MIT cohort. Patients having VAT or MIT were more satisfied with the cosmetic result than patients
who underwent conventional treatment, but no significant differences in patient satisfaction were found between the VAT and
MIT groups.
Conclusions When compared with conventional treatment, VAT and MIT provided significant benefit in terms of cosmetic results and postoperative
pain. Nevertheless, the main limiting factor for minimally invasive thyroid surgery still remains the size of the thyroid.
This study was supported by grants from the Italian Ministry of University, Scientific and Technological Research. |
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