title: Incision length for standard thyroidectomy and parathyroidectomy: when is it minimally invasive?
abstract: 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.
authors.affiliation: Department of Surgery, University of California, San Francisco, USA.
authors.forename: Laurent
authors.initials: L
authors.lastname: Brunaud
authors.forename: Rasa
authors.initials: R
authors.lastname: Zarnegar
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Wada
authors.forename: Philip
authors.initials: P
authors.lastname: Ituarte
authors.forename: Orlo H
authors.initials: OH
authors.lastname: Clark
authors.forename: Quan-Yang
authors.initials: QY
authors.lastname: Duh
mesh_terms: 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*