Video-assisted thyroidectomy: report of a 7-year experience in Rome.
OBJECTIVE
We report on our series of patients selected for video-assisted thyroidectomy (VAT) over a 7-year period.


METHODS
VAT is a gasless procedure performed under endoscopic vision through a single 1.5-2.0 cm skin incision. The eligibility criteria are thyroid nodules < or =35 mm, thyroid volume <30 ml, and no previous conventional neck surgery. Small, low-risk papillary thyroid carcinomas (PTC) were considered eligible.


RESULTS
There were 521 VATs attempted. Conversion was necessary six times (difficult dissection in one case, large nodule size in three, and gross lymph node metastases in two). Thyroid lobectomy was successfully accomplished in 113 cases, total thyroidectomy in 398, and completion thyroidectomy in 14. In 66 patients, the central neck nodes were removed through the same access. Pathology showed benign diseases in 313 cases, PTC in 187, and medullary microcarcinoma in 1. Postoperative complications included 9 transient recurrent nerve palsies, 73 transient hypocalcemias, 3 definitive hypoparathyroidisms, 1 postoperative haematoma, and 2 wound infections. The cosmetic result was excellent. In patients with PTC, no evidence of recurrent disease was shown.


CONCLUSIONS
The indications for VAT are still limited. Nonetheless, in selected patients, it seems a valid option for thyroidectomy and even preferable to conventional surgery because of its significant advantages, especially in terms of cosmetic result.
Lombardi
Celestino Pio
CP
Division of Endocrine Surgery, Department of Surgery, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy.
Raffaelli
Marco
M
Princi
Pietro
P
De Crea
Carmela
C
Bellantone
Rocco
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011183:Postoperative Complications; D012008:Recurrence; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome; D020535:Video-Assisted Surgery