title: Clinical benefits of minimally invasive techniques in thyroid surgery.
abstract: BACKGROUND
  Recently there has been a strong impetus to develop minimally invasive techniques in endocrine neck surgery. This study was designed to investigate the potential benefits of two minimally invasive thyroidectomy procedures, namely video-assisted and open minimal-incision thyroidectomy (VAT and MIT, respectively) when compared with conventional thyroidectomy.
  
  
  METHODS
  Between May 2000 and June 2006, a prospective, nonrandomized study was performed on 957 consecutive patients undergoing thyroid surgery. Fifty-six (5.8%) patients underwent VAT, 214 (22.4%) underwent MIT, and 687 (71.8%) underwent a conventional procedure.
  
  
  RESULTS
  Patients were selected for VAT when total thyroid volume was < or =30 ml and for MIT when total thyroid volume was >30 but < or =80 ml as determined by ultrasonography. The length of the central neck skin incision was 1.5-2 cm for VAT, 2.5-3.5 cm for MIT, and 6-10 cm for the conventional operation. The incidence of definitive hypoparathyroidism or recurrent laryngeal palsy after VAT or MIT was comparable with that occurring after conventional treatment. Patients having VAT or MIT experienced significantly less postoperative pain than patients undergoing conventional treatment. Less pain was also registered in the VAT patient cohort when compared with the MIT cohort. Patients having VAT or MIT were more satisfied with the cosmetic result than patients who underwent conventional treatment, but no significant differences in patient satisfaction were found between the VAT and MIT groups.
  
  
  CONCLUSIONS
  When compared with conventional treatment, VAT and MIT provided significant benefit in terms of cosmetic results and postoperative pain. Nevertheless, the main limiting factor for minimally invasive thyroid surgery still remains the size of the thyroid.
authors.affiliation: Department of General Surgery, Medical School, University of Florence, Viale Morgagni 85, 50134, Florence, Italy.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Perigli
authors.forename: Camillo
authors.initials: C
authors.lastname: Cortesini
authors.forename: Etleva
authors.initials: E
authors.lastname: Qirici
authors.forename: Daniele
authors.initials: D
authors.lastname: Boni
authors.forename: Fabio
authors.initials: F
authors.lastname: Cianchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011183:Postoperative Complications; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome; D020535:Video-Assisted Surgery