Skip to main content
Top
Published in: Annals of Surgical Oncology 2/2006

01-02-2006

Minimally Invasive Video-Assisted Thyroidectomy for Follicular Neoplasm: Is There an Advantage Over Conventional Thyroidectomy?

Authors: Michael B. Ujiki, MD, Cord Sturgeon, MD, Daphne Denham, MD, Linwah Yip, MD, Peter Angelos, MD, PhD

Published in: Annals of Surgical Oncology | Issue 2/2006

Login to get access

Abstract

Background

Minimally invasive video-assisted thyroidectomy (MIVAT) is safe and effective for selected patients, but its advantages are not clearly defined. Results of MIVAT for follicular neoplasms at a single institution were retrospectively evaluated to define its advantages or disadvantages.

Methods

Between October 2002 and May 2004, 22 patients underwent MIVAT. Twenty-six patients who underwent conventional thyroidectomy during the same time period served as matched controls. Operative times, pathologic findings, complications, analgesic requirements, and incision lengths were retrospectively evaluated.

Results

Four MIVAT and three conventional surgery patients underwent total thyroidectomy. Eighteen MIVAT and 23 conventional patients underwent hemithyroidectomy. The operative time (mean ± SEM) for hemithyroidectomy was 102 ± 4 minutes for MIVAT and 86 ± 3 minutes for conventional surgery (P < .05). In subgroup analysis that excluded patients with thyroiditis, operative times were not significantly different: MIVAT, 99 ± 4 minutes; conventional, 88 ± 4 minutes. The mean incision length was 2.3 ± .5 cm in the MIVAT group. Conventional thyroidectomy was performed through a 4- to 5-cm incision. The average amount of narcotic used was not significantly different (intravenous, 9.9 ± 3.1 mg [MIVAT] vs. 12.4 ± 3.8 mg; oral, 10.3 ± 4.2 mg [MIVAT] vs. 3.5 ± 2.0 mg). The conventional group received more cyclooxygenase 2 inhibitor (527 ± 9 mg vs. 187 ± 84 mg; P < .05). One patient in each group experienced transient hoarseness. There were no cases of permanent hypoparathyroidism or recurrent laryngeal nerve injury in either group.

Conclusions

MIVAT is as safe and effective as conventional thyroidectomy and is associated with similar narcotic analgesic requirements, but it can be performed through smaller incisions. Operative times were significantly longer for MIVAT, but when patients with thyroiditis were excluded, operative times were not significantly different.
Literature
1.
go back to reference Huscher CS, Recher A, Napolitano G, Chiodini S. Endoscopic right thyroid lobectomy. Surg Endosc 1997;11:877. PubMed Huscher CS, Recher A, Napolitano G, Chiodini S. Endoscopic right thyroid lobectomy. Surg Endosc 1997;11:877. PubMed
2.
go back to reference Yeung CH, Ng WT, Kong CK. Endoscopic surgery of the neck: a new frontier. Surg Laparosc Endosc 1998;8:227–32CrossRefPubMed Yeung CH, Ng WT, Kong CK. Endoscopic surgery of the neck: a new frontier. Surg Laparosc Endosc 1998;8:227–32CrossRefPubMed
3.
go back to reference Miccoli P, Berti P, Raffaelli M, Materazzi G, Baldacci S, Rossi G. Comparison between minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study. Surgery 2001;130:1039–43CrossRefPubMed Miccoli P, Berti P, Raffaelli M, Materazzi G, Baldacci S, Rossi G. Comparison between minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study. Surgery 2001;130:1039–43CrossRefPubMed
4.
go back to reference Bellantone R, Lombardi CP, Raffaelli M, Rubino F, Boscherini M, Perilli W. Minimally invasive, totally gasless video-assisted thyroid lobectomy. Am J Surg 1999;177:342–3CrossRefPubMed Bellantone R, Lombardi CP, Raffaelli M, Rubino F, Boscherini M, Perilli W. Minimally invasive, totally gasless video-assisted thyroid lobectomy. Am J Surg 1999;177:342–3CrossRefPubMed
5.
go back to reference Miccoli P, Berti P, Raffaelli M, Conte M, Materazzi G, Galleri D. Minimally invasive video-assisted thyroidectomy. Am J Surg 2001;181:567–70CrossRefPubMed Miccoli P, Berti P, Raffaelli M, Conte M, Materazzi G, Galleri D. Minimally invasive video-assisted thyroidectomy. Am J Surg 2001;181:567–70CrossRefPubMed
7.
go back to reference Haugen BR, Woodmansee WW, McDermott MT. Towards improving the utility of fine-needle aspiration biopsy for the diagnosis of thyroid tumors. Clin Endocrinol 2002;56:281–90CrossRef Haugen BR, Woodmansee WW, McDermott MT. Towards improving the utility of fine-needle aspiration biopsy for the diagnosis of thyroid tumors. Clin Endocrinol 2002;56:281–90CrossRef
8.
go back to reference Miccoli P, Bellantone R, Mourad M, Walz M, Raffaelli M, Berti P. Minimally invasive video-assisted thyroidectomy: multiinstitutional experience. World J Surg 2002;26:972–5CrossRefPubMed Miccoli P, Bellantone R, Mourad M, Walz M, Raffaelli M, Berti P. Minimally invasive video-assisted thyroidectomy: multiinstitutional experience. World J Surg 2002;26:972–5CrossRefPubMed
9.
go back to reference Chao TC, Lin JD, Chen MF. Video-assisted open thyroid lobectomy through a small incision. Surg Laparosc Endosc Percutan Tech 2004;14:15–9PubMed Chao TC, Lin JD, Chen MF. Video-assisted open thyroid lobectomy through a small incision. Surg Laparosc Endosc Percutan Tech 2004;14:15–9PubMed
10.
go back to reference Schabram J, Vorlander C, Wahl RA. Differentiated operative strategy in minimally invasive, video-assisted thyroid surgery results in 196 patients. World J Surg 2004;28:1282–6CrossRefPubMed Schabram J, Vorlander C, Wahl RA. Differentiated operative strategy in minimally invasive, video-assisted thyroid surgery results in 196 patients. World J Surg 2004;28:1282–6CrossRefPubMed
11.
go back to reference Miccoli P, Berti P, Materazzi G, Minuto M, Barellini L. Minimally invasive video-assisted thyroidectomy: five years of experience. J Am Coll Surg 2004;199:243–8CrossRefPubMed Miccoli P, Berti P, Materazzi G, Minuto M, Barellini L. Minimally invasive video-assisted thyroidectomy: five years of experience. J Am Coll Surg 2004;199:243–8CrossRefPubMed
12.
go back to reference Sosa JA, Bowman HM, Tielsch JM, Powe NR, Gordon TA, Udelsman R. The importance of surgeon experience for clinical and economic outcomes from thyroidectomy. Ann Surg 1998;228:320–30PubMed Sosa JA, Bowman HM, Tielsch JM, Powe NR, Gordon TA, Udelsman R. The importance of surgeon experience for clinical and economic outcomes from thyroidectomy. Ann Surg 1998;228:320–30PubMed
13.
go back to reference Bellantone R, Lombardi CP, Bossola M, et al. Video-assisted vs conventional thyroid lobectomy. Arch Surg 2002;137:301–5PubMed Bellantone R, Lombardi CP, Bossola M, et al. Video-assisted vs conventional thyroid lobectomy. Arch Surg 2002;137:301–5PubMed
14.
go back to reference Ikeda Y, Takami H, Sasaki Y, Takayama J, Kurihara H. Are there significant benefits of minimally invasive endoscopic thyroidectomy? World J Surg 2004;28:1075–8CrossRefPubMed Ikeda Y, Takami H, Sasaki Y, Takayama J, Kurihara H. Are there significant benefits of minimally invasive endoscopic thyroidectomy? World J Surg 2004;28:1075–8CrossRefPubMed
Metadata
Title
Minimally Invasive Video-Assisted Thyroidectomy for Follicular Neoplasm: Is There an Advantage Over Conventional Thyroidectomy?
Authors
Michael B. Ujiki, MD
Cord Sturgeon, MD
Daphne Denham, MD
Linwah Yip, MD
Peter Angelos, MD, PhD
Publication date
01-02-2006
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 2/2006
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/ASO.2006.03.057

Other articles of this Issue 2/2006

Annals of Surgical Oncology 2/2006 Go to the issue