Incision length for standard thyroidectomy and parathyroidectomy: when is it minimally invasive?
OBJECTIVE
Current techniques for open conventional thyroidectomy or parathyroidectomy have evolved to enable a shorter incision (main proposition), and the length of the incision is influenced by objective factors.


METHODS
Case series.


METHODS
University referral center.


METHODS
Retrospective study of the most recent 200 primary consecutive routine thyroid and parathyroid operations (excluding neck dissections).


METHODS
The length of incision was routinely measured with a ruler before the incision. Univariate and multivariate analysis was performed to distinguish variables affecting length of incision.


RESULTS
Mean length of the incision was 5.5 cm for total thyroidectomy, 4.6 cm for lobectomy, and 3.5 cm for parathyroidectomy (P<.001). It was 4.1 cm for bilateral parathyroid exploration, but was reduced to 3.2 and 2.8 cm for unilateral (P<.001) and focal (P<.001) explorations, respectively. By multiple regression analysis, thyroid specimen volume and patient body mass index were independent predictors of incision length in thyroidectomy. Extent of exploration and resident training level were independent predictors of incision length in parathyroidectomy.


CONCLUSIONS
Current techniques for open conventional thyroidectomy or parathyroidectomy have evolved to enable a shorter incision. Thyroid volume, patient body mass index, extent of the planned parathyroid exploration, and the resident clinical training stage are important variables for incision length in open operation and should be taken into account when minimally invasive thyroidectomy and parathyroidectomy are evaluated.
Brunaud
Laurent
L
Department of Surgery, University of California, San Francisco, USA.
Zarnegar
Rasa
R
Wada
Nobuyuki
N
Ituarte
Philip
P
Clark
Orlo H
OH
Duh
Quan-Yang
QY
D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D016105:Parathyroidectomy / Q000379:methods*; D012044:Regression Analysis; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013965:Thyroidectomy / Q000379:methods*