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A Journal on Surgery
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,877
Minerva Chirurgica 2013 June;68(3):307-14
Minimally invasive video-assisted thyroidectomy: four-year experience of a single team in a General Surgery Unit
Scerrino G. 1, Paladino N. C. 1, Di Paola V. 1, Morfino G. 1, Inviati A. 1, Amodio E. 2, Gulotta G. 1, Bonventre S. 1
1 Unit of General and Emergency Surgery Department of General and Emergency and Transplant Surgery (GENURTO), “P. Giaccone” University Hospital, Palermo, Italy;
2 G. D’Alessandro Department of Science for the Promotion of Health, University Hospital, Palermo, Italy
Aim: Minimally invasive video-assisted thyroidectomy (MIVAT) is a surgical technique that has showed increasingly good results, particularly in endocrine surgery centers. The aim of this prospective, non-randomized study was to evaluate feasibility, advantages and critical aspects of MIVAT in a general surgery unit.
Methods: Two hundred twenty-four patients underwent total thyroidectomy for benign thyroid disease from May, 2008 to April, 2011. They were divided into two groups: one underwent conventional thyroidectomy (CT), and the other underwent MIVAT. The inclusion criteria were thyroid volume ≤35 mL and main nodule size ≤35 mm. For each patient, socio-demographic variables, hospitalization data and outcome measures (complication rate, operating time, post-operative pain, observer and patient scar assessment scale [OSAS and PSAS, respectively]) were collected. Multivariate regression analyses were done to assess the principal covariates affecting these outcome measures.
Results: There were 125 MIVATs and 99 CTs performed. The two groups were characterized by difference in age (38.4 vs. 50.9 years) and thyroid volume (18.6 vs. 23.3 mL). OSAS/PSAS scores were statistically significant in the MIVAT group (P<0.001 and P<0.001, respectively) even after adjusting for age and thyroid volume. Complication rate was similar in the two groups.
Conclusion: MIVAT significantly decreased postoperative pain and improved cosmetic results. It can be performed in younger patients and in all cases in which there is a clear indication for the procedure. Its advantages were confirmed in a general surgery unit where correct indications were followed