Safety of video-assisted thyroidectomy versus conventional surgery.
BACKGROUND
Thyroid gland manipulation, surgical stress response, and postoperative outcome in cases of video-assisted thyroidectomy (VAT) and conventional thyroidectomy were compared to verify the safety of VAT.


METHODS
Twenty consenting patients were randomly assigned to undergo VAT or conventional thyroidectomy. Serum thyroglobulin levels were monitored as indicators of thyroid manipulation, and C-reactive protein and white blood cell count were monitored to assess surgical stress response. Thyroid capsule integrity and the presence of spilled cells in the thyroid bed were verified.


RESULTS
No significant differences were found in the indicators of thyroid gland manipulation and surgical stress response between groups. No thyroid capsules ruptured, and no spilled thyroid cells were found. Patients who had VAT experienced less pain, required fewer analgesics, and were more satisfied with the cosmetic result and the surgical outcome.


CONCLUSIONS
VAT is as safe as conventional thyroidectomy and is characterized by a less painful postoperative course and by better cosmetic results and postoperative outcome.
Divisione di Endocrinochirurgia, Istituto di Clinica Chirurgica, Dipartimento di Scienze Chirurgiche, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00168 Rome, Italy.
Celestino Pio
CP
Lombardi
Marco
M
Raffaelli
Pietro
P
Princi
Paola
P
Lulli
Esther Diana
ED
Rossi
Guido
G
Fadda
Rocco
R
Bellantone
D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000032:analysis; D002291:Carcinoma, Papillary / Q000601:surgery*; D004954:Esthetics; D005260:Female; D006801:Humans; D020910:Ketorolac / Q000627:therapeutic use; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D011446:Prospective Studies; D013954:Thyroglobulin / Q000097:blood; D013964:Thyroid Neoplasms / Q000601:surgery*; D016606:Thyroid Nodule / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D020535:Video-Assisted Surgery
D000894:Anti-Inflammatory Agents, Non-Steroidal; D002097:C-Reactive Protein; D013954:Thyroglobulin; D020910:Ketorolac