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Published in: World Journal of Surgery 5/2006

01-05-2006

Video-assisted Thyroidectomy: Report on the Experience of a Single Center in More than Four Hundred Cases

Authors: Celestino Pio Lombardi, MD, Marco Raffaelli, MD, Pietro Princi, MD, Carmela De Crea, MD, Rocco Bellantone, MD

Published in: World Journal of Surgery | Issue 5/2006

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Abstract

Background

We report on our series of patients selected for video-assisted thyroidectomy (VAT) over a 7-year period and discuss the results obtained.

Methods

Video-assisted thyroidectomy is a gasless procedure performed under endoscopic vision through a single 1.5–2.0-cm skin incision, using a technique very similar to conventional surgery. Eligibility criteria were these: thyroid nodules <35 mm; thyroid volume <30 ml; no previous conventional neck surgery. Small, low-risk, papillary thyroid carcinomas (PTC) were considered eligible.

Results

A total of 473 VATs were attempted on 459 patients. Locoregional anesthesia was used in 15 patients. Conversion was necessary in 6 (difficult dissection in 1 case, large nodule size in 3, gross lymph node metastases in 2). Thyroid lobectomy was successfully performed in 110 cases, total thyroidectomy in 343, and completion thyroidectomy in 14. In 66 patients with carcinoma, central neck nodes were removed through the same access. Concomitant parathyroidectomy was performed in 14 patients. Pathology showed benign disease in 277 cases, PTC in 175, and medullary microcarcinoma in 1. Postoperative complications included 8 transient recurrent nerve palsies, 64 transient hypocalcemias, 3 definitive hypocalcemias, 1 postoperative hematoma, and 2 wound infections. Postoperative pain was minimal and the cosmetic result excellent. In patients with PTC no evidence of recurrent or residual disease was shown.

Conclusions

Indications for VAT are still limited (20% of patients who require thyroidectomy). Nonetheless, in selected patients, it seems a valid option for thyroidectomy and it could be considered even preferable to conventional surgery because of its significant advantages, especially in terms of cosmetic result.
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Metadata
Title
Video-assisted Thyroidectomy: Report on the Experience of a Single Center in More than Four Hundred Cases
Authors
Celestino Pio Lombardi, MD
Marco Raffaelli, MD
Pietro Princi, MD
Carmela De Crea, MD
Rocco Bellantone, MD
Publication date
01-05-2006
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 5/2006
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-005-0390-5

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