Minimally Invasive Thyroidectomy for Thyroid Carcinoma

  • Roy Phitayakorn


The abstract should read, “This chapter is an evidence-based review of the current medical literature on the use of minimally invasive thyroidectomy (MIT) techniques for thyroid carcinoma. Specifically, we will review various guidelines from different organizations and compare these guidelines to results with MIT in the literature. This review is structured around several themes including the use of MIT techniques for the surgical management of indeterminate thyroid nodules, papillary and micropapillary thyroid carcinoma, medullary thyroid carcinoma, prophylactic and therapeutic central neck compartment lymphadenectomy, and lateral neck compartment lymphadenectomy.”


Papillary Thyroid Carcinoma Thyroid Nodule Differentiate Thyroid Cancer Medullary Thyroid Cancer Central Neck Dissection 
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.


  1. Al-Rawi M, Wheeler MH (2006) Medullary thyroid carcinoma: update and present management controversies. Ann R Coll Surg Engl 88:433–438PubMedCrossRefGoogle Scholar
  2. Baloch ZW, LiVolsi VA, Asa SL et al (2008) Diagnostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagn Cytopathol 36:425–437PubMedCrossRefGoogle Scholar
  3. Bellantone R, Lombardi CP, Bossola M et al (2002) Video-assisted vs conventional thyroid lobectomy: a randomized trial. Arch Surg 137(3):301–304PubMedCrossRefGoogle Scholar
  4. Brandi ML, Gagel RF, Angeli A et al (2001) Guidelines for diagnosis and therapy of MEN type 1 and type 2. J Clin Endocrinol Metab 86:5658–5671PubMedCrossRefGoogle Scholar
  5. Chao TC, Lin JD, Chen MF (2004a) Video-assisted open thyroid lobectomy through a small incision. Surg Laparosc Endosc Percutan Tech 14(1):15–19PubMedCrossRefGoogle Scholar
  6. Chao TC, Lin JD, Chen MF (2004b) Gasless video-assisted total thyroidectomy in the treatment of low risk intrathyroid papillary carcinoma. World J Surg 28(9):876–879PubMedCrossRefGoogle Scholar
  7. Chiovato L, Latrofa F, Braverman LE et al (2003) Disappearance of humoral thyroid autoimmunity after complete removal of thyroid antigens. Ann Intern Med 139(5 Pt 1):346–351PubMedGoogle Scholar
  8. Chung YS, Choe JH, Kang KH et al (2007) Endoscopic thyroidectomy for thyroid malignancies: comparison with conventional open thyroidectomy. World J Surg 31(12):2302–2306PubMedCrossRefGoogle Scholar
  9. Davies L, Welch HG (2006) Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA 295(18):2164–2167PubMedCrossRefGoogle Scholar
  10. de Groot JW, Links TP, Plukker JT et al (2006) RET as a diagnostic and therapeutic target in sporadic and hereditary endocrine tumors. Endocr Rev 27:535–560PubMedCrossRefGoogle Scholar
  11. Del Rio P, Sommaruga L, Cataldo S et al (2008) Minimally invasive video-assisted thyroidectomy: the learning curve. Eur Surg Res 41(1):33–36PubMedCrossRefGoogle Scholar
  12. Del Rio P, Sommaruga L, Pisani P et al (2009) Minimally invasive video-assisted thyroidectomy in differentiated thyroid cancer: a 1-year follow-up. Surg Laparosc Endosc Percutan Tech 19(4):290–292PubMedCrossRefGoogle Scholar
  13. Engeland A, Tretli S, Akslen LA et al (2006) Body size and thyroid cancer in two million Norwegian men and women. Br J Cancer 95(3):366–370PubMedCrossRefGoogle Scholar
  14. Frank-Raue K, Buhr H, Dralle H et al (2006) Long-term outcome in 46 gene carriers of hereditary medullary thyroid carcinoma after prophylactic thyroidectomy: impact of individual RET genotype. Eur J Endocrinol 155:229–236PubMedCrossRefGoogle Scholar
  15. Gagner M, Inabnet WB 3rd (2001) Endoscopic thyroidectomy for solitary thyroid nodules. Thyroid 11(2):161–163PubMedCrossRefGoogle Scholar
  16. Goodman MT, Kolonel LN, Wilkens LR (1992) The association of body size, reproductive factors and thyroid cancer. Br J Cancer 66(6):1180–1184PubMedCrossRefGoogle Scholar
  17. Hannibal CG, Jensen A, Sharif H et al (2008) Risk of thyroid cancer after exposure to fertility drugs: results from a large Danish cohort study. Hum Reprod 23(2):451–456PubMedCrossRefGoogle Scholar
  18. Haugen BR, Woodmansee WW, McDermott MT (2002) Towards improving the utility of fine-needle aspiration biopsy for the diagnosis of thyroid tumors. Clin Endocrinol 56:281–290CrossRefGoogle Scholar
  19. Hegazy MA, Khater AA, Setit AE et al (2007) Minimally invasive video-assisted thyroidectomy for small follicular thyroid nodules. World J Surg 31(9):1743–1750PubMedCrossRefGoogle Scholar
  20. Hegedus L (2004) Clinical practice: the thyroid nodule. N Engl J Med 351:1764–1771PubMedCrossRefGoogle Scholar
  21. Heinrich S, Schafer M, Rousson V et al (2006) Evidence-based treatment of acute pancreatitis: a look at established paradigms. Ann Surg 243:154–168PubMedCrossRefGoogle Scholar
  22. Hur SM, Kim SH, Lee SK et al (2011) Is a thyroid follicular neoplasm a good indication for endoscopic surgery? Surg Laparosc Endosc Percutan Tech 21(3):e148–e151PubMedCrossRefGoogle Scholar
  23. Ikeda Y, Takami H, Sasaki Y et al (2002) Minimally invasive video-assisted thyroidectomy and lymphadenectomy for micropapillary carcinoma of the thyroid. J Surg Oncol 80:218–221PubMedCrossRefGoogle Scholar
  24. Jeong JJ, Kang SW, Yun JS et al (2009) Comparative study of endoscopic thyroidectomy versus conventional open thyroidectomy in papillary thyroid microcarcinoma (PTMC) patients. J Surg Oncol 100(6):477–480PubMedCrossRefGoogle Scholar
  25. Kang SW, Jeong JJ, Yun JS et al (2009) Gasless endoscopic thyroidectomy using trans-axillary approach; surgical outcome of 581 patients. Endocr J 56:361–369PubMedCrossRefGoogle Scholar
  26. Kelman AS, Rathan A, Leibowitz J et al (2001) Thyroid cytology and the risk of malignancy in thyroid nodules: importance of nuclear atypia in indeterminate specimens. Thyroid 11:271–277PubMedCrossRefGoogle Scholar
  27. Kitagawa W, Shimizu K, Akasu H et al (2003) Endoscopic neck surgery with lymph node dissection for papillary carcinoma of the thyroid using a totally gasless anterior neck skin lifting method. J Am Coll Surg 196:990–994PubMedCrossRefGoogle Scholar
  28. Kitano H, Fujimura M, Kinoshita T et al (2002) Endoscopic thyroid resection using cutaneous elevation in lieu of insufflation. Surg Endosc 16:88–91PubMedCrossRefGoogle Scholar
  29. Kim JH, Choi YJ, Kim JA, Gil WH, Nam SJ, Oh YL, Yang JH (2008) Thyroid cancer that developed around the operative bed and subcutaneous tunnel after endoscopic thyroidectomy via a breast approach. Surg Laparosc Endosc Percutan Tech 18(2):197–201Google Scholar
  30. Koh YW, Kim JW, Lee SW et al (2009) Endoscopic thyroidectomy via a unilateral axillo-breast approach without gas insufflation for unilateral benign thyroid lesions. Surg Endosc 23(9):2053–2060PubMedCrossRefGoogle Scholar
  31. Kuppersmith RB, Holsinger FC (2011) Robotic thyroid surgery: an initial experience with North American patients. Laryngoscope 121(3):521–526PubMedCrossRefGoogle Scholar
  32. Lee KE, Koo do H, Kim SJ et al (2010) Outcomes of 109 patients with papillary thyroid carcinoma who underwent robotic total thyroidectomy with central node dissection via the bilateral axillo-breast approach. Surgery 148(6):1207–1213PubMedCrossRefGoogle Scholar
  33. Li Z, Wang P, Wang Y, Xu S, Cao L, Que R, Zhou F (2011) Endoscopic lateral neck dissection via breast approach for papillary ­thyroid carcinoma: a preliminary report. Surg Endosc 25(3):890–896Google Scholar
  34. Liu S, Qiu M, Jiang DZ et al (2009) The learning curve for endoscopic thyroidectomy: a single surgeon’s experience. Surg Endosc 23(8):1802–1806PubMedCrossRefGoogle Scholar
  35. Lloyd R, De Lellis R, Heitz P et al (2004) World Health Organization classification of tumours: pathology and genetics of tumours of the endocrine organs. IARC, LyonGoogle Scholar
  36. Lombardi CP, Raffaelli M, Princi P, Lulli P, Rossi ED, Fadda G, Bellantone R (2005) Safety of video-assisted thyroidectomy versus conventional surgery. Head Neck 27(1):58–64Google Scholar
  37. Lombardi CP, Raffaelli M, de Crea C et al (2007a) Report on 8 years of experience with video-assisted thyroidectomy for papillary thyroid carcinoma. Surgery 142(6):944–951PubMedCrossRefGoogle Scholar
  38. Lombardi CP, Raffaelli M, Princi P et al (2007b) Minimally invasive video-assisted functional lateral neck dissection for metastatic papillary thyroid carcinoma. Am J Surg 193:114–118PubMedCrossRefGoogle Scholar
  39. Lundgren CI, Stalberg P, Grodski S et al (2007) Minimally invasive thyroid surgery for diagnostic excision of solitary thyroid nodules. Asian J Surg 30(4):250–254PubMedCrossRefGoogle Scholar
  40. Machens A, Gimm O, Hinze R et al (2001) Genotype–phenotype correlations in hereditary medullary thyroid carcinoma: oncological features and biochemical properties. J Clin Endocrinol Metab 86:1104–1109PubMedCrossRefGoogle Scholar
  41. McHenry CR, Phitayakorn R (2011) Follicular adenoma and carcinoma of the thyroid gland. Oncologist 16(5):585–593PubMedCrossRefGoogle Scholar
  42. Miccoli P, Elisei R, Materazzi G et al (2002) Minimally invasive video-assisted thyroidectomy for papillary carcinoma: a prospective study of its completeness. Surgery 132(6):1070–1073PubMedCrossRefGoogle Scholar
  43. Miccoli P, Elisei R, Donatini G et al (2007) Video-assisted ­central compartment lymphadenectomy in a patient with a positive RET oncogene: initial experience. Surg Endosc 21(1):120–123PubMedCrossRefGoogle Scholar
  44. Miccoli P, Materazzi G, Berti P (2008) Minimally invasive video-assisted lateral lymphadenectomy: a proposal. Surg Endosc 22:1131–1134PubMedCrossRefGoogle Scholar
  45. Miccoli P, Pinchera A, Materazzi G et al (2009) Surgical treatment of low- and intermediate-risk papillary thyroid cancer with minimally invasive video-assisted thyroidectomy. J Clin Endocrinol Metab 94(5):1618–1622PubMedCrossRefGoogle Scholar
  46. Miccoli P, Materazzi G, Berti P (2010) Minimally invasive thyroidectomy in the treatment of well differentiated thyroid cancers: indications and limits. Curr Opin Otolaryngol Head Neck Surg 18(2):114–118PubMedCrossRefGoogle Scholar
  47. Neidich MJ, Steward DL (2011) Safety and feasibility of elective minimally invasive video-assisted central neck dissection for thyroid carcinoma. Head Neck. doi:10.1002/hed.21733Google Scholar
  48. Papavramidis TS, Michalopoulos N, Pliakos J et al (2010) Minimally invasive video-assisted total thyroidectomy: an easy to learn technique for skillful surgeons. Head Neck 32(10):1370–1376PubMedCrossRefGoogle Scholar
  49. Perrier ND, Randolph GW, Inabnet WB et al (2010) Robotic thyroidectomy: a framework for new technology assessment and safe implementation. Thyroid 20(12):1327–1332PubMedCrossRefGoogle Scholar
  50. Rezzonico J, Rezzonico M, Pusiol E et al (2008) Introducing the thyroid gland as another victim of the insulin resistance syndrome. Thyroid 18(4):461–464PubMedCrossRefGoogle Scholar
  51. Roti E, degli Uberti EC, Bondanelli M et al (2008) Thyroid ­papillary microcarcinoma: a descriptive and meta-analysis study. Eur J Endocrinol 159(6):659–673PubMedCrossRefGoogle Scholar
  52. Sackett DL (1989) Rules of evidence and clinical recommendations on the use of anti-thrombotic agents. Chest 95:2S–4S, 23PubMedGoogle Scholar
  53. Scheuba C, Kaserer K, Bieglmayer C et al (2007) Medullary thyroid microcarcinoma recommendations for treatment – a single-center experience. Surgery 142:1003–1010PubMedCrossRefGoogle Scholar
  54. Sherman SI (2003) Thyroid carcinoma. Lancet 361(9356):501–511Google Scholar
  55. Shimizu K, Kitagawa W, Akasu H, Tanaka S (2001) Endoscopic hemithyroidectomy and prophylactic lymph node dissection for micropapillary carcinoma of the thyroid by using a totally gasless anterior neck skin lifting method. J Surg Oncol 77(3):217–220Google Scholar
  56. Spencer CA, Takeuchi M, Kazarosyan M et al (1998) Serum thyroglobulin autoantibodies: prevalence, influence on serum thyroglobulin measurement, and prognostic significance in patients with differentiated thyroid carcinoma. J Clin Endocrinol Metab 83(4):1121–1127PubMedCrossRefGoogle Scholar
  57. Tuttle RM, Lemar H, Burch HB (1998) Clinical features associated with an increased risk of thyroid malignancy in patients with follicular neoplasia by fine-needle aspiration. Thyroid 8:377–383PubMedCrossRefGoogle Scholar
  58. Tyler DS, Winchester DJ, Caraway NP et al (1994) Indeterminate fine-needle aspiration biopsy of the thyroid: identification of subgroups at high risk for invasive carcinoma. Surgery 116:1054–1060PubMedGoogle Scholar
  59. Ujiki MB, Sturgeon C, Denham D et al (2006) Minimally invasive video-assisted thyroidectomy for follicular neoplasm: is there an advantage over conventional thyroidectomy? Ann Surg Oncol 13(2):182–186PubMedCrossRefGoogle Scholar
  60. Wu CT, Yang LH, Kuo SJ (2010) Comparison of video-assisted thyroidectomy and traditional thyroidectomy for the treatment of papillary thyroid carcinoma. Surg Endosc 24(7):1658–1662PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Endocrine Surgery UnitThe Massachusetts General Hospital, Harvard Medical SchoolBostonUSA

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