title: Minimal-access video-assisted thyroidectomy for benign disease: a retrospective analysis of risk factors for postoperative complications.
abstract: BACKGROUND
  Minimal-access video-assisted thyroidectomy (MIVAT) has now become a widespread technique in the treatment of benign thyroid disease. No studies systematically investigate risk factors for postoperative complications. The aim of our study was to investigate possible risk factors for postoperative complications in MIVAT in patients with benign disease.
  
  
  METHODS
  One-hundred eighty-nine patients who underwent MIVAT for benign disease were retrospectively identified in a prospectively-maintained institutional register of thyroid surgery. Exclusion criteria were: (1) thyroid volume>45 mL; (2) malignant disease; (3) prior neck surgery; (4) prior neck irradiation; (5) nodule size>3 cm; (6) intrathoracic component; (7) follow-up<1 year. Age, sex, comorbidities, body mass index, existence of symptoms, duration of disease evolution, thyroid volume, hyperthyroidism, thyroiditis, and the duration of surgery were analyzed as risk factors for complications. We applied both bivariate and multivariate logistic regression analyses in order to identify risk factors associated with postoperative complications.
  
  
  RESULTS
  Complications were presented by 28 patients (14.8%). The variables associated as independent risk factors with these complications were hyperthyroidism (OR = 4.31; P = 0.003) and thyroiditis (OR = 3.59; P = 0.035). Age, sex and thyroid volume up to 45 mL do not seem to be independent risk factors.
  
  
  CONCLUSIONS
  In endocrine surgery units, two independent risk factors for postoperative complications could be identified in MIVAT patients: hyperthyroidism and thyroiditis. Surgeons operating on patients presenting these factors should be aware of the potential augmented risk in order to correctly adapt intraoperative and postoperative care.
authors.affiliation: Department of Surgery, Section of Endocrine Surgery, Universitätsklinikum Freiburg, Hugstetter Strasse 55, D-79106, Freiburg im Breisgau, Germany; Department of Abdominal, Endocrine and Vascular Surgery, St. Vincentius Kliniken, Südendstrasse 32, D-76133, Karlsruhe, Germany. Electronic address: franck.billmann@wanadoo.fr.
authors.forename: Franck
authors.initials: F
authors.lastname: Billmann
authors.affiliation: Department of Thoracic Surgery, Universitätsklinikum Freiburg, Hugstetter Strasse 55, D-79106, Freiburg im Breisgau, Germany.
authors.forename: Therezia
authors.initials: T
authors.lastname: Bokor-Billmann
authors.affiliation: Department of Surgery, Section of Endocrine Surgery, Universitätsklinikum Freiburg, Hugstetter Strasse 55, D-79106, Freiburg im Breisgau, Germany.
authors.forename: Hryhoriy
authors.initials: H
authors.lastname: Lapshyn
authors.affiliation: Department of Surgery, USA Health Center, Vicenza, Italy.
authors.forename: Claude
authors.initials: C
authors.lastname: Burnett
authors.affiliation: Department of Surgery, Section of Endocrine Surgery, Universitätsklinikum Freiburg, Hugstetter Strasse 55, D-79106, Freiburg im Breisgau, Germany.
authors.forename: Ulrich T
authors.initials: UT
authors.lastname: Hopt
authors.affiliation: Department of Abdominal, Endocrine and Vascular Surgery, St. Vincentius Kliniken, Südendstrasse 32, D-76133, Karlsruhe, Germany.
authors.forename: Erhard
authors.initials: E
authors.lastname: Kiffner
mesh_terms: D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000150:complications; D008297:Male; D009333:Neck / Q000601:surgery; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects* / Q000379:methods; D013966:Thyroiditis / Q000150:complications; D020535:Video-Assisted Surgery / Q000009:adverse effects*
keywords: MIVAT; Risk factor; Thyroid; Thyroidectomy; Video-assisted surgery