Safety and feasibility of thyroid lobectomy via a lateral 2.5-cm incision with a cohort comparison of the first 50 cases: evolution of a surgical approach
- 74 Downloads
Background and aims
Over 500 minimal-access parathyroidectomies (MIPs) have been performed in our unit, and, from these, a technique for thyroid resection has evolved. We present a report on the evolution of minimal-access thyroid surgery (MATS) and compare the results with those from a cohort of patients operated on prior to the use of MATS.
We reviewed the evolution towards the MATS technique. The results of the MATS procedures were compared with those from an equal number of consecutive patients undergoing conventional lobectomy prior to the use of MATS.
Fifty patients (mean age 45.6 years) underwent MATS between March 2002 and May 2004. The mean nodule diameter was 18.5 mm. In the MATS group there was one recurrent laryngeal nerve (RLN) injury, two temporary RLN neuropraxias, which recovered, and one haematoma. The control group (mean age 47.9 years) had a mean nodule size of 22 mm. In the controls there was one temporary RLN neuropraxia, which recovered, and two haematomas—P>0.05 (Fisher’s exact test) for all the complications.
MATS has evolved from an experimental approach into a safe and feasible surgical procedure based on the same operative approach as used for MIP. It provides an alternative to open thyroid surgery in appropriately selected cases.
KeywordsMinimal access Thyroidectomy Lateral approach Thyroid nodule
- 1.Duh QY (2003) Presidential address: minimal access endocrine surgery—standard of treatment or hype? Surgery 134:849–857Google Scholar
- 2.Agarwal G, Barraclough BH, Reeve TS, Delbridge LW (2002) Minimally invasive parathyroidectomy using the ‘focused’ lateral approach. II. Surgical technique. ANZ J Surg 72:147–151Google Scholar
- 3.Bliss RD, Gauger PG, Delbridge LW (2000) Surgeon’s approach to the thyroid gland: surgical anatomy and the importance of technique. World J Surg 24:891–897Google Scholar
- 4.Palazzo FF, Delbridge LW (2004) Minimal-access/minimally invasive parathyroidectomy for primary hyperparathyroidism. Surg Clin North Am 84:717–734Google Scholar
- 6.Gauger PG, Reeve TS, Delbridge LW (1999) Endoscopically assisted, minimally invasive parathyroidectomy. Br J Surg 86:1563–1566Google Scholar
- 7.Delbridge LW (2003) Minimally invasive parathyroidectomy: the Australian experience. Asian J Surg 26:76–81Google Scholar
- 8.Sackett WR, Barraclough BH, Sidhu S, Reeve TS, Delbridge LW (2002) Minimal access thyroid surgery: is it feasible, is it appropriate? ANZ J Surg 72:777–780Google Scholar
- 10.Brunaud L, Zarnegar R, Wada N, Ituarte P, Clark OH, Duh QY (2003) Incision length for standard thyroidectomy and parathyroidectomy. When is it minimally invasive? Arch Surg 138:1140–1143Google Scholar
- 11.Huscher CS, Chiodini S, Napolitano C, Recher A (1997) Endoscopic right thyroid lobectomy. Surg Endosc 11:877Google Scholar
- 12.Miccoli P, Berti P, Raffaelli M, Conte M, Materazzi G, Galleri D (2001) Minimally invasive video-assisted thyroidectomy. Am J Surg 181:567–570Google Scholar
- 13.Ikeda Y, Takami H, Niimi M, Kan S, Sasaki Y, Takayama J (2001) Endoscopic thyroidectomy by the axillary approach. Surg Endosc 15:1362–1364Google Scholar
- 14.Ohgami M, Ishii S, Arisawa Y, Ohmori T, Noga K, Furukawa T, Kitijama M (2000) Scarless endoscopic thyroidectomy: breast approach for better cosmesis. Surg Laparosc Endosc Percutan Tech 10:1–4Google Scholar
- 15.Sidhu S, Campbell P (2000) Thyroid pathology associated with primary hyperparathyroidism. Aust N Z J Surg 70:285–287Google Scholar
- 17.Inabnet WB, Jacob BP, Gagner M (2003) Minimally invasive endoscopic thyroidectomy by a cervical approach. Surg Endosc 17:1808–1811Google Scholar