Advertisement

World Journal of Surgery

, Volume 31, Issue 9, pp 1743–1750 | Cite as

Minimally Invasive Video-Assisted Thyroidectomy for Small Follicular Thyroid Nodules

  • Mohamed A. F. Hegazy
  • Ashraf A. Khater
  • Ahmed E. Setit
  • Mahmoud A. Amin
  • Sherif Z. Kotb
  • Mohamed A. El Shafei
  • Tamer F. Yousef
  • Osama Hussein
  • Yousef K. Shabana
  • Ola T. Abdel Dayem
Article

Abstract

Minimal access surgery in the thyroid compartment has evolved considerably over the past 10 years and now takes many forms. This study examined the feasibility and reliability of minimally invasive thyroid surgery for the management of small benign thyroid lesions. A total of 68 patients with small thyroid nodules admitted to the Oncology Center of Mansoura University, Egypt, were enrolled in this prospective randomized trial. Patients were allotted to one of two procedures: minimally invasive video-assisted thyroidectomy (MIVAT) or minimally invasive open thyroidectomy using the Sofferman technique of strap muscle transection. Exclusion criteria were nodules > 4 cm, presence of thyroiditis, and thyroid gland volume > 20 ml. Preoperative diagnosis, operating time, blood loss, postoperative pain, complications, and cosmetic outcome were all evaluated. The MIVAT group included 35 patients, and the Sofferman group included 33 patients. The main preoperative pathology was a benign follicular lesion (70.5%), and the main postoperative final pathology was follicular adenoma (54.4%). The two groups were comparable regarding age, sex, and extent of thyroid surgery. Operating time was significantly longer in the MIVAT group (115.4 ± 33.5 minutes) compared to the Sofferman group (65.6 ± 23.7 minutes). The postoperative course was significantly less painful in the MIVAT group (p < 0.05). Although patients in the MIVAT group had smaller incisions (p < 0.05), the cosmetic outcome in the two groups was comparable. No long-term complication was encountered in either group. Two distinct approaches of minimally invasive thyroidectomy are now available and can be performed safely in selected patients. Despite some MIVAT advantages of less postoperative pain and slightly better cosmesis, minimally invasive open thyroidectomy offers an advantage of less operating time with comparable cosmetic results.

Keywords

Thyroid Nodule Total Thyroidectomy Recurrent Laryngeal Nerve Palsy Follicular Neoplasm Endoscopic Thyroidectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Mouret P (1996) How I developed laparoscopic cholecystectomy. Ann Acad Med Singapore 25:744–747PubMedGoogle Scholar
  2. 2.
    Gagner M, Inabnet MB (2000) Minimally invasive thyroid surgery. In: Gagner M, Inabnet WB, (editors), Minimally Invasive Endocrine Surgery Workshop, New York, Mount Sinai Hospital, pp 1–10Google Scholar
  3. 3.
    Husscher CSG, Napolitano C, Chiodini S, et al. (1997) Video assisted thyroidectomy. Eur J Coelio 3:57Google Scholar
  4. 4.
    Miccoli P, Berti P, Conte M, et al. (2000) Minimally invasive video-assisted surgery of the thyroid: a preliminary report. Langenbecks Arch Surg 385:262–264CrossRefGoogle Scholar
  5. 5.
    Ishii S, Ohgami M, Arisawa Y, et al. (1998) Endoscopic thyroidectomy with anterior chest wall approach. Surg Endosc 12:611Google Scholar
  6. 6.
    Takami H, Ikeda Y (2002) Endoscopic thyroidectomy via an axillary or anterior chest approach. In: Gagner M, Inabnet WB, (editors). Minimally Invasive Endocrine Surgery, 1st edition. Philadelphia, Lippincott Williams & Wilkins, pp 56–63Google Scholar
  7. 7.
    Miccoli P, Berti P, Raffaelli M, et al. (2000) Comparison between minimally invasive video assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study. Surgery 130:1039–1043CrossRefGoogle Scholar
  8. 8.
    Ferzli G, sayad P, Abdo Z, et al. (2001) Minimally invasive non-endoscopic thyroid surgery. J Am Coll Surg 192:665–668PubMedCrossRefGoogle Scholar
  9. 9.
    Takami H, Ikeda Y (2006) Minimally invasive thyroidectomy. Curr Opin Oncol 18:43–47PubMedCrossRefGoogle Scholar
  10. 10.
    Terris DJ, Bonnett A, Gourin CG, et al. (2005) Minimally invasive thyroidectomy using the Sofferman technique. Laryngoscope 115:1104–1108PubMedCrossRefGoogle Scholar
  11. 11.
    Lo Gerfo P (1998) Invited commentary. Surg Endosc 3:206CrossRefGoogle Scholar
  12. 12.
    Ikeda Y, Tamaki H, Sasaki Y, et al. (2002) Comparative study of thyroidectomies: endoscopic surgery vs. open surgery. Surg Endosc 16:1741–1745CrossRefGoogle Scholar
  13. 13.
    Ohgami M, Ishii S, Ohmori T, et al. (2000) Scarless endoscopic thyroidectomy: breast approach better cosmesis. Surg Laparosc Endosc Percut Tech 10:1–4CrossRefGoogle Scholar
  14. 14.
    Reeve TS, Delbridge L, Sloan D, et al. (1986) The impact of fine needle aspiration biopsy on surgery for single thyroid nodules. Med J Aust 145:308–311PubMedGoogle Scholar
  15. 15.
    Sackett WR, Barraclough BH, Sidhu S, et al. (2002) Minimal access thyroid surgery: is it feasible, is it appropriate? ANZ J Surg 72:777–780PubMedCrossRefGoogle Scholar
  16. 16.
    Terris DJ, Gourin CG, Chin EM (2006) Minimally invasive thyroidectomy: basic and advanced techniques. Laryngoscope 116:350–356PubMedCrossRefGoogle Scholar
  17. 17.
    Terris DJ, Chin E (2006) Clinical implementation of endoscopic thyroidectomy in selected patients. Laryngoscope 116:1745–1748PubMedCrossRefGoogle Scholar
  18. 18.
    Ballantone R, Lombardi CP, Bossola M, et al. (2002) Video-assisted vs conventional thyroid lobectomy: a randomized trial. Arch Surg 137:301–304CrossRefGoogle Scholar
  19. 19.
    Miccoli P, Berti P, Materazzi G, et al. (2004) Minimally invasive video- assisted thyroidectomy: five years of experience. J Am Coll Surg 199:243–248PubMedCrossRefGoogle Scholar
  20. 20.
    Ruggieri M, Straniero A, Mascaro M, et al. (2005) The minimally invasive open video- assisted approach in surgical thyroid diseases. BMC Surg 27:9CrossRefGoogle Scholar
  21. 21.
    Burguera B, Gharib H (2000) Thyroid incidentalomas: prevalence, diagnosis, significance, and management. Endocrinol Metab 14:559–575Google Scholar
  22. 22.
    Mortensen IC, Woolner LB, Bennett WA (1955) Gross and microscopic findings in clinically normal thyroid glands. J Clin Endocrinol Metab 15:1270–1280PubMedCrossRefGoogle Scholar
  23. 23.
    Zdon MJ, Fredeland AJ, Zaret PH (2001) Follicular neoplasms of the thyroid: predictors of malignancy? Am Surg 67:880–884PubMedGoogle Scholar
  24. 24.
    Barbaro D, Simi U, Lopan P, et al. (2001) Thyroid nodules with microfollicular findings reported on fine needle aspiration: invariably surgical treatment? Endocr Pract 7:352–357PubMedGoogle Scholar
  25. 25.
    Mikosch P, Wartner U, Keresnik E, et al. (2001) Results of preoperative ultrasound guided fine needle aspiration biopsy of solitary thyroid nodules as compared with histology: a retrospective analysis of 538 patients [abstract]. Nuklearmedizin 40:148–154PubMedGoogle Scholar
  26. 26.
    Cohen MS, Arslan N, Dehdashi F, et al. (2001) Risk of malignancy in thyroid incidentalomas identified by fluorodeoxyglucose- positron emission tomography. Surg 130: 941–946CrossRefGoogle Scholar
  27. 27.
    Mackinnon WB, Delbridge L, Russel P, et al. (1996) Two dimensional proton magnetic resonance spectroscopy for tissue characterization of thyroid neoplasms. World J Surg 20:841–847PubMedCrossRefGoogle Scholar
  28. 28.
    Barolazzi A, Gasbarri A, Papotti M, et al. (2001) Application of an immunodiagnostic method for improving preoperative diagnosis of nodular thyroid lesions. Lancet 537:1644–1650CrossRefGoogle Scholar
  29. 29.
    Reeve TS, Delbridge L, Cohen A (1987) Total thyroidectomy: the preferred option for multinodular goiter. Ann Surg 206:782PubMedCrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2007

Authors and Affiliations

  • Mohamed A. F. Hegazy
    • 1
  • Ashraf A. Khater
    • 1
  • Ahmed E. Setit
    • 1
  • Mahmoud A. Amin
    • 2
  • Sherif Z. Kotb
    • 1
  • Mohamed A. El Shafei
    • 1
  • Tamer F. Yousef
    • 1
  • Osama Hussein
    • 1
  • Yousef K. Shabana
    • 3
  • Ola T. Abdel Dayem
    • 4
  1. 1.Department of Surgical OncologyMansoura University HospitalMansouraEgypt
  2. 2.Department of General SurgeryMansoura University HospitalMansouraEgypt
  3. 3.Department of OtorhinolaryngologyMansoura University HospitalMansouraEgypt
  4. 4.Departments of Anesthesia and Intensive CareMansoura University HospitalMansouraEgypt

Personalised recommendations