Minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study

Gál, István; Solymosi, Tamás; Szabó, Zoltán; Bálint, A; Bolgar, Gyorgy

doi:10.1007/s00464-008-9806-2

Cited by 58 publications

(55 citation statements)

References 21 publications

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“…It should be noted, however, that such procedures are technically demanding and require a surgical team skilled in both endocrine and endoscopic surgery. This is particularly true in the case of some endoscopic techniques that require a significant learning period, which can be time consuming, especially early in a surgical career [24,25].…”

Section: Discussionmentioning

confidence: 99%

Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy

et al. 2010

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Background Robotic thyroidectomy using a gasless transaxillary approach, first described in 2008, has become popular. This study compared outcomes, including postoperative distress and patient satisfaction, for patients undergoing robotic thyroidectomy with those for patients treated by conventional open thyroidectomy. Methods Of 84 prospectively enrolled patients, 41 underwent robotic thyroidectomy (the robot group), and 43 received conventional open thyroidectomy (the open group). All the patients were followed up for at least 3 months after surgery. Videolaryngostroboscopic examinations were performed preoperatively and after 1 week and after 3 months postoperatively. Postoperative pain and discomfort were evaluated using a symptom scale. Subjective voice and swallowing changes were assessed by questionnaires; and satisfaction with cosmetic outcome was measured by verbal response at 3 months. Results The two groups were similar in age, gender, type of operation, and final pathologic diagnosis. Although the mean operating time was significantly longer with the robotic technique than with open surgery, there were no betweengroup differences in postoperative pain or duration of hospital stay. No patient in either group experienced any major postoperative complication. Postoperative discomfort in the neck and swallowing disturbances were significantly more frequent in the open group than in the robot group, both at 1 week and at 3 months after surgery. However, there was no significant between-group difference in subjective voice parameters. At 3 months, the mean cosmetic satisfaction score was significantly higher in the robotic than in the open group. Conclusion Although postoperative pain levels and complications were comparable in the two groups, conventional open thyroidectomy requires a shorter operative time. The robotic technique, however, offers several distinct advantages including very good to excellent cosmetic results, reduced postoperative neck discomfort, and fewer adverse swallowing symptoms.Keywords Comparative study Á Cosmetic result Á Postoperative neck discomfort Á Robotic thyroidectomy Á Swallowing symptom Most patients with thyroid tumors are effectively treated surgically by practitioners experienced in the techniques of thyroidectomy. Many patients, especially women, undergoing thyroid surgery are concerned about the postoperative cosmetic appearance of the neck. Neck surgery also may result in postoperative discomfort, with pain, hyperesthesia, and paresthesia [1][2][3].

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Section: Discussionmentioning

confidence: 99%

Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy

et al. 2010

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“…The difference between these techniques is based on the type of the port. ABBA technique involves the use of two circumareolar ports and a single axillary port, whereas BABA is performed by using two circumareolar ports and two axillary ports [3,[5][6][7]9]. This technique now is even improved by using Da vinci robotic system by Lee et al [6] which is useful in identification of anatomy and dissection during surgery.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Right Lobectomy Axillary-breast Approach: Report of Two Cases

Irawati¹

2010

WJOLS

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Background. We reported our two initial experiences in the treatment of thyroid disease with endoscopic thyroidectomy. Minimally invasive video-assisted technique (MIVAT) was initially introduced by Miccoli. The modification was made by using axillary and breast technique. Method. Two young women patients, with 4 and 5 cm right lobe thyroid disease suspected to be benign. From physical examination, sonography, and FNAB findings, the two cases were categorized as benign. We performed endoscopic right lobectomy through incision of 5-10 mm on axillary line and breast using CO2 insufflation. Result. Duration of first operation was 300 minutes and the second one was 120 minutes, with minimal blood loss and no major complication. Patients were discharged 24 hours after operation. Cosmetic result was excellent. Postoperative complications were shoulder discomfort and neck swelling. Conclusion. We reported two cases of endoscopic right lobectomy as a safe, reproducible technique with an indication in a minority of patients candidates for thyroidectomy and is characterized by less postoperative discomfort.

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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%

“…The classic collar incision for CT ranges from 3.5cm to 8.2cm. 7,8,10,13,16 The OMIT scar had a mean length of 3.3cm. 14 MIVAT scars ranged from 1.7cm to 3.2cm.…”

Section: Incision Lengthmentioning

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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Minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study

Abstract: Although the complications are comparable between the two approaches, conventional thyroidectomy involves less operative time. However, MIVAT offers distinct advantages to selected patients in terms of very good to exellent cosmetic results and reduced postoperative distress.

Cited by 58 publications

References 21 publications

Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy

Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy

Endoscopic Right Lobectomy Axillary-breast Approach: Report of Two Cases

Short and long-term cosmesis of cervical thyroidectomy scars

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