Conventional versus miniinvasive video-assisted thyroidectomy: Limits and benefits of the miniinvassive approach
Abstract
Thyroidectomy represents the most common type of endocrine surgery in the head and neck region. As an alternative to the conventional type of thyroid surgery, large number of different cervical and extracervical approaches was developed, with the main goal to improve cosmetic outcome, accelerate healing and increase patient’s comfort after the procedure.
In our prospective study we focused on comparison of the conventional thyroidectomy and minimally invasive video-assisted thyroidectomy (MIVAT). There were 60 patients in each group, undergoing partial or total thyroidectomy.
Avarage length of partial thyroidectomy was 56 min in the conventional and 72 min in case of MIVAT procedures, in case of total thyroidectomy it was 100 min in conventional and 105 min respectively. There was less bleeding following MIVAT procedures documented with volume of blood collected with active drainage system.
Active drainage was not employed in 10 patients undergoing MIVAT surgery. There was tendency for less pain following MIVAT procedures.
Significant reduction of pain was documented by patients at 6th hour following total thyroidectomy. Furthermore less opioids needed on the day of surgery and lower consumption of analgetics since the 1st postoperative day following total thyroidectomy was observed in the MIVAT group.
In both groups we observed 1 permanent and 1 transient RLN palsy. Permanent postoperative hypoparathyreosis was not observed.
There was shorter postoperative hospitalization time in case of MIVAT partial procedures. In compliance with the indication criteria, MIVAT is applicable in selected number of patients undergoing thyroid surgery.
Increased postoperative comfort and favorable cosmetic outcome represent the main potential benefits of this technique for the patient.