Minimally invasive video-assisted thyroidectomy versus conventional thyroidectomy: A single-blinded, randomized controlled clinical trial.
We aimed to test the hypothesis that Minimally Invasive Video-assisted Thyroidectomy (MIVAT) affords comparable safety and efficacy as to the open conventional surgery, when dealing with patients with unilateral thyroid nodules or follicular lesions, in terms of cosmetic results, intraoperative and postoperative complications, postoperative pain and hospital stay.


METHODS
This was a single-blinded randomised controlled trial comparing the MIVAT with conventional thyroidectomy. The primary endpoints of the study were measurement of postoperative pain after 24 and 48 hours from operation and self-rated patient satisfaction with cosmetic outcome three months postoperatively. The secondary outcome measures were operative time, incidence of temporary and permanent recurrent laryngeal nerve injury, postoperative haematoma formation, length of incision, and duration of hospital stay.


RESULTS
Operative time was significantly less with open thyroidectomy than with MIVAT, while MIVAT was associated with less pain 24 hours postoperatively. Blood loss did not reach significance between procedures. Comparisons between the two procedures with regard to pain scores after 24 and 48 hours, respectively, depicted statistically significant differences in favour of the MIVAT after 24 hours. MIVAT was associated with less scarring and more satisfactory cosmetic results. There were statistically no significant differences between both procedures for the presence of transient recurrent laryngeal nerve palsy and hypoparathyroidism.


CONCLUSIONS
MIVAT is a safe procedure that produces outcomes, in view of short-term adverse events, similar to those of open thyroidectomy, and is superior in terms of immediate postoperative pain and cosmetic results.
El-Labban
Gouda M
GM
Department of Surgery, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
J Am Coll Surg. 2004 Aug;199(2):243-8
15275880
Langenbecks Arch Surg. 2008 May;393(3):271-3
17909847
World J Surg. 2007 Sep;31(9):1743-1750
17653588
Laryngoscope. 2004 Aug;114(8):1377-82
15280711
Surgery. 2003 Dec;134(6):849-57
14668714
Surg Endosc. 1997 Nov;11(11):1135
9348395
Biomed Pharmacother. 2002;56 Suppl 1:60s-63s
12487254
Surg Endosc. 2006 Feb;20(2):339-42
16362471
Am J Surg. 2004 Apr;187(4):515-8
15041502
BMC Surg. 2005 Apr 27;5:9
15857503
J Am Coll Surg. 1999 Jun;188(6):697-703
10359365
Arch Otolaryngol Head Neck Surg. 2008 Jan;134(1):81-4
18209142
Langenbecks Arch Surg. 2006 Jun;391(3):174-7
16528568
World J Surg. 2004 Nov;28(11):1075-8
15490052
Surgery. 1998 Dec;124(6):1077-9; discussion 1079-80
9854586
Ann Chir. 1999;53(4):302-6
10327694
Surg Endosc. 2002 Dec;16(12):1741-5
12140635
Otolaryngol Head Neck Surg. 2006 Nov;135(5):744-7
17071305
Eur Rev Med Pharmacol Sci. 2003 Jul-Aug;7(4):91-6
15068231
Am J Surg. 2001 Jun;181(6):567-70
11513788
Laryngoscope. 2005 Jun;115(6):1104-8
15933531
Best Pract Res Clin Endocrinol Metab. 2001 Jun;15(2):123-37
11472029
Surg Endosc. 2001 Nov;15(11):1362-4
11727158
Am J Surg. 1999 Apr;177(4):342-3
10326857
Thyroid. 2008 Jul;18(7):721-7
18631000
Surgery. 2001 Dec;130(6):1039-43
11742335
J Endocrinol Invest. 1999 Dec;22(11):849-51
10710272
Surg Endosc. 2002 Jan;16(1):3-6
11961594
Surg Endosc. 2002 Apr;16(4):663-6
11972210
World J Surg. 2008 Jul;32(7):1333-40
18305997
Ann Surg Oncol. 2006 Feb;13(2):182-6
16411145
J Endocrinol Invest. 1997 Jul-Aug;20(7):429-30
9309543
Br J Surg. 1996 Jun;83(6):875
8696772
Surg Endosc. 1997 Aug;11(8):877
9266657
Surg Laparosc Endosc Percutan Tech. 2000 Feb;10(1):1-4
10872517
Ann Ital Chir. 2003 Jan-Feb;74(1):3-5; discussion 6-7
12870275
Biomed Pharmacother. 2002;56 Suppl 1:72s-78s
12487257
Surgery. 2002 Dec;132(6):1070-3; discussion 1073-4
12490857
J Am Coll Surg. 2002 May;194(5):610-4
12022601
J Am Coll Surg. 2002 Oct;195(4):573-4
12375766
Surgery. 2008 Dec;144(6):1016-21; discussion 1021-2
19041012
Surg Endosc. 2008 Nov;22(11):2445-9
18322739
Acta Chir Belg. 2002 Oct;102(5):323-7; discussion 327-8
12471764
World J Surg. 2008 Jul;32(7):1341-8
18373119
Anesth Analg. 1997 May;84(5):1154-6
9141952
Surg Endosc. 1998 Mar;12(3):202-5; discussion 206
9502695
Laryngoscope. 2006 Oct;116(10):1745-8
17003721
J Surg Oncol. 1998 Nov;69(3):178-80
9846506
Arch Surg. 2002 Mar;137(3):301-4; discussion 305
11888453
World J Surg. 2002 Aug;26(8):972-5
12016476
Thyroid. 2001 Feb;11(2):161-3
11288985
Surg Endosc. 2003 Oct;17(10):1604-8
12874681