Minimally invasive video-assisted thyroidectomy for small follicular thyroid nodules.
Minimal access surgery in the thyroid compartment has evolved considerably over the past 10 years and now takes many forms. This study examined the feasibility and reliability of minimally invasive thyroid surgery for the management of small benign thyroid lesions. A total of 68 patients with small thyroid nodules admitted to the Oncology Center of Mansoura University, Egypt, were enrolled in this prospective randomized trial. Patients were allotted to one of two procedures: minimally invasive video-assisted thyroidectomy (MIVAT) or minimally invasive open thyroidectomy using the Sofferman technique of strap muscle transection. Exclusion criteria were nodules > 4 cm, presence of thyroiditis, and thyroid gland volume > 20 ml. Preoperative diagnosis, operating time, blood loss, postoperative pain, complications, and cosmetic outcome were all evaluated. The MIVAT group included 35 patients, and the Sofferman group included 33 patients. The main preoperative pathology was a benign follicular lesion (70.5%), and the main postoperative final pathology was follicular adenoma (54.4%). The two groups were comparable regarding age, sex, and extent of thyroid surgery. Operating time was significantly longer in the MIVAT group (115.4 +/- 33.5 minutes) compared to the Sofferman group (65.6 +/- 23.7 minutes). The postoperative course was significantly less painful in the MIVAT group (p < 0.05). Although patients in the MIVAT group had smaller incisions (p < 0.05), the cosmetic outcome in the two groups was comparable. No long-term complication was encountered in either group. Two distinct approaches of minimally invasive thyroidectomy are now available and can be performed safely in selected patients. Despite some MIVAT advantages of less postoperative pain and slightly better cosmesis, minimally invasive open thyroidectomy offers an advantage of less operating time with comparable cosmetic results.
Hegazy
Mohamed A F
MAF
Department of Surgical Oncology, Mansoura University Hospital, El Gomhoria St., Mansoura, Egypt. mhegazy68@yahoo.com.
Khater
Ashraf A
AA
Department of Surgical Oncology, Mansoura University Hospital, El Gomhoria St., Mansoura, Egypt.
Setit
Ahmed E
AE
Department of Surgical Oncology, Mansoura University Hospital, El Gomhoria St., Mansoura, Egypt.
Amin
Mahmoud A
MA
Department of General Surgery, Mansoura University Hospital, El Gomhoria St., Mansoura, Egypt.
Kotb
Sherif Z
SZ
Department of Surgical Oncology, Mansoura University Hospital, El Gomhoria St., Mansoura, Egypt.
Shafei
Mohamed A El
MAE
Department of Surgical Oncology, Mansoura University Hospital, El Gomhoria St., Mansoura, Egypt.
Yousef
Tamer F
TF
Department of Surgical Oncology, Mansoura University Hospital, El Gomhoria St., Mansoura, Egypt.
Hussein
Osama
O
Department of Surgical Oncology, Mansoura University Hospital, El Gomhoria St., Mansoura, Egypt.
Shabana
Yousef K
YK
Department of Otorhinolaryngology, Mansoura University Hospital, El Gomhoria St., Mansoura, Egypt.
Dayem
Ola T Abdel
OTA
Departments of Anesthesia and Intensive Care, Mansoura University Hospital, El Gomhoria St., Mansoura, Egypt.
D000236:Adenoma / Q000601:surgery*; D000328:Adult; D004534:Egypt; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011446:Prospective Studies; D016606:Thyroid Nodule / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D020535:Video-Assisted Surgery / Q000379:methods