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

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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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References

  1. Duh QY. Presidential address: minimally invasive endocrine surgery—standard of treatment or hype? Surgery 2003;134:849–857

    Article  PubMed  Google Scholar 

  2. Huscher CS, Chiodini S, Napolitano C, et al. Endoscopic right thyroid lobectomy. Surg Endosc 1997;11:877

    Article  CAS  PubMed  Google Scholar 

  3. Gagner M, Inabnet WB. Endoscopic thyroidectomy for solitary thyroid nodules. Thyroid 2001;11:161–163

    Article  CAS  PubMed  Google Scholar 

  4. Yeung GH. Endoscopic surgery of the neck: a new frontier. Surg Laparosc Endosc 1998;8:227–232

    Article  CAS  PubMed  Google Scholar 

  5. Shimizu K, Akira S, Jasmi AY, et al. Video-assisted neck surgery: endoscopic resection of thyroid tumors with a very minimal neck wound. J Am Coll Surg 1999;188:697–703

    Article  CAS  PubMed  Google Scholar 

  6. Yeh TS, Jan YY, Hsu BR, et al. Video-assisted endoscopic thyroidectomy. Am J Surg 2000;180:82–85

    Article  CAS  PubMed  Google Scholar 

  7. Ikeda Y, Takami H, Tajima G, et al. Total endoscopic thyroidectomy: axillary or anterior chest approach. Biomed Pharmacother 2002;56(1):72s–78s

    Article  PubMed  Google Scholar 

  8. Ohgami M, Ishii S, Arisawa Y, et al. Scarless endoscopic thyroidectomy: breast approach for better cosmesis. Surg Laparosc Endosc Percutan Tech 2000;10:1–4

    Article  CAS  PubMed  Google Scholar 

  9. Bellantone R, Lombardi CP, Raffaelli M, et al. Minimally invasive, totally gasless video-assisted thyroid lobectomy. Am J Surg 1999;177:342–343

    Article  CAS  PubMed  Google Scholar 

  10. Miccoli P, Berti P, Bendinelli C, et al. Minimally invasive video-assisted surgery of the thyroid: a preliminary report. Langenbecks Arch Surg 2000;385:261–264

    Article  CAS  PubMed  Google Scholar 

  11. Mourad M, Saab N, Malaise J, et al. Minimally invasive video-assisted approach for partial and total thyroidectomy: initial experience. Surg Endosc 2001;15:1108–111

    Article  CAS  PubMed  Google Scholar 

  12. Yamashita H, Watanabe S, Koike E, et al. Video-assisted thyroid lobectomy through a small wound in the submandibular area. Am J Surg 2002;183:286–289

    Article  PubMed  Google Scholar 

  13. Ferzli GS, Sayad P, Abdo Z, et al. Minimally invasive, nonendoscopic thyroid surgery. J Am Coll Surg 2001;192:665–668

    Article  CAS  PubMed  Google Scholar 

  14. Sackett WR, Barraclough BH, Sidhu S, et al. Minimal access thyroid surgery: is it feasible, is it appropriate? Aust N Z J Surg 2002;72:777–780

    Article  Google Scholar 

  15. Brunaud L, Zarnegar R, Wada N, et al. Incision length for standard thyroidectomy and parathyroidectomy. When is it minimally invasive? Arch Surg 2003;138:1140–1143

    Article  PubMed  Google Scholar 

  16. Gagner M. Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg 1996;83:875

    CAS  PubMed  Google Scholar 

  17. Bellantone R, Lombardi CP, Raffaelli M, et al. Video-assisted thyroidectomy. J Am Coll Surg 2002;194:610–614

    Article  PubMed  Google Scholar 

  18. Miccoli P, Berti P, Raffaelli M, et al. Minimally invasive video-assisted thyroidectomy. Am J Surg 2000;181:567–557

    Article  Google Scholar 

  19. Miccoli P, Bellantone R, Mourad M, et al. Minimally invasive video-assisted thyroidectomy: multiinstitutional experience. World J Surg 2002;26:972–975

    Article  PubMed  Google Scholar 

  20. Schabram J, Vorländer C, Wahl RA. Differentiated operative strategy in minimally invasive, video-assisted thyroid surgery. Results in 196 patients. World J Surg 2004;28:1282–1286

    Article  PubMed  Google Scholar 

  21. Miccoli P, Berti P, Raffaelli M, et al. Comparison between minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prospective randomised study. Surgery 2001;130:1039–1043

    Article  CAS  PubMed  Google Scholar 

  22. Bellantone R, Lombardi CP, Bossola M, et al. Video-assisted vs conventional thyroid lobectomy—a randomized trial. Arch Surg 2002;137:301–304

    Article  PubMed  Google Scholar 

  23. Lombardi CP, Raffaelli M, Princi P, et al. Safety of video-assisted thyroidectomy versus conventional surgery. Head Neck 2005;27:58–64

    Article  PubMed  Google Scholar 

  24. Miccoli P, Elisei R, Materazzi G, et al. Minimally invasive video-assisted thyroidectomy for papillary carcinoma: a prospective study of its completeness. Surgery 2002;132:1070–1074

    Article  PubMed  Google Scholar 

  25. Bellantone R, Lombardi CP, Raffaelli M, et al. Video-assisted thyroidectomy for papillary thyroid carcinoma Surg Endosc 2003;17:1604–1608

    Article  CAS  PubMed  Google Scholar 

  26. Lombardi CP, Raffaelli M, Modesti C, et al. Video-assisted thyroidectomy under local anesthesia. Am J Surg 2004;187:515–518

    Article  PubMed  Google Scholar 

  27. Shaha AR. Implications of prognostic factors and risk group in the management of differentiated thyroid cancer. Laryngoscope 2004;114:393–402

    Article  PubMed  Google Scholar 

  28. Bellantone R, Lombardi CP, Raffaelli M, et al. Central neck lymph node removal during minimally invasive video-assisted thyroidectomy for thyroid carcinoma: a feasible and safe procedure. J Laparoendosc Adv Surg Tech A 2002;12:181–185

    Article  PubMed  Google Scholar 

  29. Goropoulos A, Karamoshos K, Christodoulou A, et al. Value of cervical compartments in the surgical treatment of papillary thyroid carcinoma. World J Surg 2004;28:1275–1281

    Article  PubMed  Google Scholar 

  30. Miccoli P, Berti P, Materazzi G, et al. Minimally invasive video-assisted thyroidectomy: five years experience. J Am Coll Surg 2004;199:243–248

    Article  PubMed  Google Scholar 

  31. Reeve T, Thompson NW. Complications of thyroid surgery: how to avoid them, how to manage them, and observations on their possible effect on the whole patient. World J Surg 2000;24:971–975

    Article  CAS  PubMed  Google Scholar 

  32. Manolidis S, Takashima M, Kirby M, et al. Thyroid surgery: a comparison of outcomes between experts and surgeons in training. Otolaryngol Head Neck Surg 2001;125:30–33

    Article  CAS  PubMed  Google Scholar 

  33. Mirallié E, Visset J, Sagan C, et al. Localization of cervical node metastasis of papillary thyroid carcinoma. World J Surg 1999;23:970–974

    Article  PubMed  Google Scholar 

  34. Kebebew E, Clark OH. Differentiated thyroid cancer: “complete” rational approach. World J Surg 2000;24:942–951

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Endocrine Surgery, Department of Surgery, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy

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

  2. Divisione di Endocrinochirurgia, Istituto di Clinica Chirurgica, Dipartimento di Scienze Chirurgiche, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168, Rome, Italy

    Marco Raffaelli MD

Authors
  1. Celestino Pio Lombardi MD
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  2. Marco Raffaelli MD
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  3. Pietro Princi MD
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  4. Carmela De Crea MD
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  5. Rocco Bellantone MD
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Corresponding author

Correspondence to Marco Raffaelli MD.

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Lombardi, C.P., Raffaelli, M., Princi, P. et al. Video-assisted Thyroidectomy: Report on the Experience of a Single Center in More than Four Hundred Cases. World J. Surg. 30, 794–800 (2006). https://doi.org/10.1007/s00268-005-0390-5

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  • DOI: https://doi.org/10.1007/s00268-005-0390-5

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