Cosmesis and Body Image after Minimally Invasive or Open Thyroid Surgery

Bokor, Therezia; Kiffner, E.; Kotrikova, B.; Billmann, Franck

doi:10.1007/s00268-012-1563-7

Cited by 36 publications

(39 citation statements)

References 45 publications

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“…There have been few more previous studies which have derived similar conclusions [2][3][4][5]; however, none have been as extensive as the present study. The sample size is large and very heterogeneous; therefore, there can be many confounding factors which I would like to highlight.…”

contrasting

confidence: 37%

Letter to the Editor regarding “Reducing neck incision length during thyroid surgery does not improve satisfaction in patients” by Kim et al.

Bakshi

2015

Eur Arch Otorhinolaryngol

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contrasting

confidence: 37%

Letter to the Editor regarding “Reducing neck incision length during thyroid surgery does not improve satisfaction in patients” by Kim et al.

Bakshi

2015

Eur Arch Otorhinolaryngol

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“…In the authors' experience only 15% of patients were candidates for the procedure (26). Lower figures (10% or less) have been reported from regions where goitre is endemic (37). Another disadvantage of MIVAT is that despite its satisfying long-term cosmetic outcomes, it is not protective against kelloids (40,41).…”

Section: Mivat's Disadvantagesmentioning

confidence: 83%

“…While this has been demonstrated by many (7,27) studies, others concluded that a shorter cervical scar was not associated with improved patient satisfaction (36)(37)(38). Furthermore, it may be argued that shorter incisions may compromise the safety of a procedure without favorably influencing patient satisfaction (39).…”

Section: Mivat's Advantagesmentioning

confidence: 88%

Minimally Invasive Video-Assisted Thyroidectomy (MIVAT) in the Era of Minimal Access Thyroid Surgery

Bakkar

Miccoli

2017

J Minim Invasive Surg Sci

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Background: In the era of minimal access thyroid surgery, the terms minimal access and minimally invasive are often used interchangeably and in most instances this is far from being accurate. The aim of this article is to examine the characteristics and potential of one of the first minimal access thyroid procedures described; minimally invasive video-assisted thyroidectomy (MI-VAT). Methods: The purpose of this article was obtained by almost two decades of experiences with the procedure at the authors' center, and a systemic literature review was undertaken of all available medical literature to evaluate available literature by conducting a PubMed search limited to articles originally written in English language between the years 1997 and 2016. The search was limited by using the terms: minimally invasive thyroid surgery, video-assisted, endoscopic, and robotic thyroidectomy. The procedure's design, radicality and safety, learning curve, cost, advantages and disadvantages were addressed. MIVAT's potential as a surgical tool for thyroid pathology was also addressed by evaluating its indications, contraindications, and limitations. Results: MIVAT is a gasless hybrid procedure that is comparable to conventional thyroidectomy (CT) in terms of radicality and safety, with the added advantage of reduced early postoperative voice and swallowing symptoms. MIVAT has a relatively rapid learning curve with an additional advantage over other minimal access procedures; the ability of being adopted by the low-volume surgeon at a cost and time comparable to CT, but with improved patient satisfaction. Furthermore, it is non-inferior to procedures free of a neck scar in terms of patient satisfaction. MIVAT's main drawback is that it is limited by its strict selection criteria. It is a viable treatment option for all types of thyroid pathologies. However, its role in therapeutic neck dissection remains to be validated. Conclusions: MIVAT is a safe and effective procedure which is obviously described in its name "minimally invasive". It seems that in the era of innovative technologies and scarless-in-the neck thyroid surgery, MIVAT is here to stay.

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“…Fiftyseven relevant thyroidectomy papers were identified, twenty of which reported some form of cosmetic outcome assessment. These included 6 randomised controlled trials (RCTs) with 412 patients (evidence level 2B), [6][7][8][9][10][11] 7 cohort studies with 3,073 patients (level 3B) [12][13][14][15][16][17][18] and 7 non-comparative case series with 1,575 patients (level 4). [19][20][21][22][23][24][25] The remaining studies made reference to the issue of cosmesis either by assumption, referencing or general statements unsupported by methodological assessment.…”

Section: Review Resultsmentioning

confidence: 99%

Short and long-term cosmesis of cervical thyroidectomy scars

Dordea

Aspinall

2016

annals

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INTRODUCTION Multiple surgical approaches to the thyroid gland have been described via cervical or extracervical routes. Improved cosmesis, patient satisfaction, reduced pain (procedure dependent) and early discharge have all been reported for minimally invasive approaches with similar safety profiles and long-term outcomes to conventional surgery. This review summarises the current evidence base for improved cosmesis with minimally invasive cervical approaches to the thyroid gland compared with conventional surgery. METHODS A systematic review was undertaken. The MEDLINE ® , Embase™ and Cochrane databases were searched for relevant articles. RESULTS A total of 57 papers thyroid papers were identified. Of those, 20 reported some form of cosmetic outcome assessment. There were 6 randomised controlled trials with 412 patients (evidence level 2B), 7 cohort studies with 3,073 patients (level 3B) and 7 non-comparative case series with 1,575 patients (level 4). There was significant heterogeneity between studies in terms of wound closure technique, timing of scar assessment and scar assessment scales (validated and non-validated). Most studies performed early scar assessments, some using non-validated scar assessment tools. CONCLUSIONS Assessment of cosmesis is complex and requires rigorous methodology. Evidence from healing/remodelling studies suggests scar maturation is a long-term process. This calls into question the value of early scar assessment. Current evidence does not support minimally invasive surgical approaches to the thyroid gland if improved long-term cosmesis is the goal. KEYWORDSThyroidectomy -Minimally invasive video assisted thyroidectomy -Scar -Cosmesis

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Cosmesis and Body Image after Minimally Invasive or Open Thyroid Surgery

Cited by 36 publications

References 45 publications

Letter to the Editor regarding “Reducing neck incision length during thyroid surgery does not improve satisfaction in patients” by Kim et al.

Letter to the Editor regarding “Reducing neck incision length during thyroid surgery does not improve satisfaction in patients” by Kim et al.

Minimally Invasive Video-Assisted Thyroidectomy (MIVAT) in the Era of Minimal Access Thyroid Surgery

Short and long-term cosmesis of cervical thyroidectomy scars

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