title: Minimally invasive compared with conventional thyroidectomy for nodular goitre.
abstract: Since minimally invasive thyroidectomy was introduced in 1997, different surgical approaches to the thyroid have been described: the minimal neck incision and the anterior chest, areolar breast or axillary access. Whereas conventional open thyroidectomy is suitable for any thyroid disease, minimal neck incision thyroidectomy or extracervical scarless neck thyroidectomy are limited to small-volume disease. In 11 prospective randomized studies and six systematic reviews, minimally invasive video-assisted thyroidectomy via a central or lateral neck approach afforded better cosmesis in the first 3 months than conventional open thyroidectomy, with less postoperative pain for the first 48 h. Surgical morbidity did not differ in these limited studies. No head-to-head comparison is available for extracervical scarless neck thyroidectomy and conventional open thyroidectomy. Extracervical scarless neck thyroidectomy caused more postoperative pain and gave rise to complications not seen with minimal neck incision thyroidectomy or conventional open thyroidectomy. In the absence of evidence to the contrary, conventional open thyroidectomy continues to remain the gold standard for any nodular goitre.
authors.affiliation: Department of General, Visceral and Vascular Surgery, University Hospital, Medical Faculty, University of Halle-Wittenberg, Ernst-Grube-Str. 40, D-06097 Halle/Saale, Germany. Electronic address: henning.dralle@uk-halle.de.
authors.forename: Henning
authors.initials: H
authors.lastname: Dralle
authors.affiliation: Department of General, Visceral and Vascular Surgery, University Hospital, Medical Faculty, University of Halle-Wittenberg, Ernst-Grube-Str. 40, D-06097 Halle/Saale, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Machens
authors.affiliation: Department of General, Visceral and Vascular Surgery, University Hospital, Medical Faculty, University of Halle-Wittenberg, Ernst-Grube-Str. 40, D-06097 Halle/Saale, Germany.
authors.forename: Phuong Nguyen
authors.initials: PN
authors.lastname: Thanh
mesh_terms: D002921:Cicatrix / Q000453:epidemiology / Q000517:prevention & control; D006044:Goiter, Nodular / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000145:classification / Q000379:methods*; D037981:Neck Dissection / Q000379:methods; D010149:Postoperative Pain / Q000453:epidemiology / Q000209:etiology; D013965:Thyroidectomy / Q000145:classification / Q000379:methods*; D016896:Treatment Outcome
keywords: extracervical scarless neck thyroidectomy (ESNT); minimal neck incision thyroidectomy (MNIT); minimally invasive video-assisted thyroidectomy (MIVAT); nodular goitre; thyroid cancer