Abstract Background In the last decade, development of videolaparoscopic surgery allowed several operations to be performed with minimally invasive techniques, making them less invasive and painful. Neck surgery was also involved in this effort, in spite of the skepticism shown by some authors. Study design Minimally invasive video-assisted thyroidectomy was developed in 1998, and since then, about 600 operations have been performed. Access was the same as was previously described for parathyroidectomy; it was based on a small central incision (1.5 cm) and on external retraction without neck insufflation. Results From July 1998 to October 2003, 579 patients were selected from 5,450 for minimally invasive video-assisted thyroidectomy. The operation consisted of a total thyroidectomy in 312 patients and lobectomy in 267 patients. Mean operative time was 41 ± 19.5 minutes (range 15 to 120 minutes) for lobectomy and 51.6 ± 18.8 minutes (range 30 to 140 minutes) for total thyroidectomy. Postoperative hospital stay was 24 hours (overnight discharge) for all patients. Complications were postoperative bleeding (0.1%), recurrent nerve palsy (1.3%), and definitive hypoparathyroidism (0.2%). Conclusions After 5 years of experience using this approach for various indications, we achieved a good esthetic result with an operative time comparable to that of conventional open surgery. Minimally invasive video-assisted thyroidectomy was found to be a safe operation, with advantages over traditional procedures represented by better cosmetic outcomes and postoperative course, as demonstrated by visual analogue scales and statistically analyzed numeric scales. © 2004 by the American College of Surgeons. Indexed keywords EMTREE medical terms: adolescent; adult; aeration; aged; article; controlled study; hospital discharge; hospitalization; human; hypoparathyroidism; laparoscopy; lobectomy; major clinical study; minimally invasive surgery; operation duration; parathyroidectomy; postoperative complication; postoperative hemorrhage; priority journal; recurrent laryngeal nerve palsy; safety; school child; statistical analysis; thyroidectomy; treatment outcome; videorecorder; visual analog scale MeSH: Adolescent; Adult; Aged; Child; Female; Humans; Male; Middle Aged; Postoperative Complications; Surgical Procedures, Minimally Invasive; Thyroidectomy; Time Factors; Video-Assisted Surgery Medline is the source for the MeSH terms of this document.
Minimally invasive video-assisted thyroidectomy: five years of experience
MICCOLI, PAOLO;BERTI, PIERO;MATERAZZI, GABRIELE;
2004-01-01
Abstract
Abstract Background In the last decade, development of videolaparoscopic surgery allowed several operations to be performed with minimally invasive techniques, making them less invasive and painful. Neck surgery was also involved in this effort, in spite of the skepticism shown by some authors. Study design Minimally invasive video-assisted thyroidectomy was developed in 1998, and since then, about 600 operations have been performed. Access was the same as was previously described for parathyroidectomy; it was based on a small central incision (1.5 cm) and on external retraction without neck insufflation. Results From July 1998 to October 2003, 579 patients were selected from 5,450 for minimally invasive video-assisted thyroidectomy. The operation consisted of a total thyroidectomy in 312 patients and lobectomy in 267 patients. Mean operative time was 41 ± 19.5 minutes (range 15 to 120 minutes) for lobectomy and 51.6 ± 18.8 minutes (range 30 to 140 minutes) for total thyroidectomy. Postoperative hospital stay was 24 hours (overnight discharge) for all patients. Complications were postoperative bleeding (0.1%), recurrent nerve palsy (1.3%), and definitive hypoparathyroidism (0.2%). Conclusions After 5 years of experience using this approach for various indications, we achieved a good esthetic result with an operative time comparable to that of conventional open surgery. Minimally invasive video-assisted thyroidectomy was found to be a safe operation, with advantages over traditional procedures represented by better cosmetic outcomes and postoperative course, as demonstrated by visual analogue scales and statistically analyzed numeric scales. © 2004 by the American College of Surgeons. Indexed keywords EMTREE medical terms: adolescent; adult; aeration; aged; article; controlled study; hospital discharge; hospitalization; human; hypoparathyroidism; laparoscopy; lobectomy; major clinical study; minimally invasive surgery; operation duration; parathyroidectomy; postoperative complication; postoperative hemorrhage; priority journal; recurrent laryngeal nerve palsy; safety; school child; statistical analysis; thyroidectomy; treatment outcome; videorecorder; visual analog scale MeSH: Adolescent; Adult; Aged; Child; Female; Humans; Male; Middle Aged; Postoperative Complications; Surgical Procedures, Minimally Invasive; Thyroidectomy; Time Factors; Video-Assisted Surgery Medline is the source for the MeSH terms of this document.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
