title: Minimally invasive video-assisted thyroidectomy: four-year experience of a single team in a General Surgery Unit.
abstract: OBJECTIVE
  Minimally invasive video-assisted thyroidectomy (MIVAT) is a surgical technique that has showed increasingly good results, particularly in endocrine surgery centers. The aim of this prospective, non-randomized study was to evaluate feasibility, advantages and critical aspects of MIVAT in a general surgery unit.
  
  
  METHODS
  Two hundred twenty-four patients underwent total thyroidectomy for benign thyroid disease from May, 2008 to April, 2011. They were divided into two groups: one underwent conventional thyroidectomy (CT), and the other underwent MIVAT. The inclusion criteria were thyroid volume ≤35 mL and main nodule size ≤35 mm. For each patient, socio-demographic variables, hospitalization data and outcome measures (complication rate, operating time, post-operative pain, observer and patient scar assessment scale [OSAS and PSAS, respectively]) were collected. Multivariate regression analyses were done to assess the principal covariates affecting these outcome measures.
  
  
  RESULTS
  There were 125 MIVATs and 99 CTs performed. The two groups were characterized by difference in age (38.4 vs. 50.9 years) and thyroid volume (18.6 vs. 23.3 mL). OSAS/PSAS scores were statistically significant in the MIVAT group (P<0.001 and P<0.001, respectively) even after adjusting for age and thyroid volume. Complication rate was similar in the two groups.
  
  
  CONCLUSIONS
  MIVAT significantly decreased postoperative pain and improved cosmetic results. It can be performed in younger patients and in all cases in which there is a clear indication for the procedure. Its advantages were confirmed in a general surgery unit where correct indications were followed.
authors.affiliation: Unit of General and Emergency Surgery Department of General and Emergency and Transplant Surgery (GENURTO), "P. Giaccone" University Hospital, Palermo, Italy - giuditta.morfino@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Scerrino
authors.forename: N C
authors.initials: NC
authors.lastname: Paladino
authors.forename: V
authors.initials: V
authors.lastname: Di Paola
authors.forename: G
authors.initials: G
authors.lastname: Morfino
authors.forename: A
authors.initials: A
authors.lastname: Inviati
authors.forename: E
authors.initials: E
authors.lastname: Amodio
authors.forename: G
authors.initials: G
authors.lastname: Gulotta
authors.forename: S
authors.initials: S
authors.lastname: Bonventre
mesh_terms: D000328:Adult; D005260:Female; D013502:General Surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010149:Postoperative Pain; D011446:Prospective Studies; D013503:Surgery Department, Hospital; D013965:Thyroidectomy / Q000379:methods*; D013997:Time Factors; D020535:Video-Assisted Surgery