title: Six-Year Experience With Endoscopic Thyroidectomy: Outcomes and Safety Profile.
abstract: BACKGROUND
  Though minimally invasive video-assisted thyroidectomy (MIVAT) offers many advantages over traditional thyroid surgery, its adoption in North America has been limited. This study analyzes the largest series of MIVAT in North America to explore its safety.
  
  
  METHODS
  A prospectively maintained database of all patients undergoing thyroid surgery by a single surgeon from 2003 to 2011 at an academic tertiary care medical center was evaluated. Demographic information, surgical and pathologic data, and postoperative outcomes were analyzed.
  
  
  RESULTS
  Beginning in 2005, a total of 260 MIVATs were performed during the study period. Outpatient surgery was accomplished in 234 MIVATs (90%). MIVAT patients were predominantly young (46.8±14.8 years vs 52.4±14.6 years for conventional thyroidectomy) and female (88.5% vs 75.5% for conventional thyroidectomy). There were no cases of permanent hypoparathyroidism or permanent recurrent laryngeal nerve dysfunction. Observed complications included transient recurrent laryngeal nerve dysfunction (n=10; 3.8%), cellulitis (n=1; 0.4%), and temporary hypocalcemia (n=6; 2.3%). The overall complication rate for MIVAT (6.5%) was lower than the overall complication rate in conventional thyroidectomy (18.5%, P<.0001).
  
  
  CONCLUSIONS
  MIVAT can be performed safely with a low complication profile in a high-volume practice. The safety of MIVAT represented by this experience supports broader adoption across surgical practices.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Georgia Regents University, Augusta, Georgia, USA.
authors.forename: William S
authors.initials: WS
authors.lastname: Duke
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Georgia Regents University, Augusta, Georgia, USA.
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: White
authors.affiliation: Department of Biostatistics and Epidemiology, Georgia Regents University, Augusta, Georgia, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Waller
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Georgia Regents University, Augusta, Georgia, USA dterris@gru.edu.
authors.forename: David J
authors.initials: DJ
authors.lastname: Terris
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000209:etiology / Q000517:prevention & control; D007011:Hypoparathyroidism / Q000209:etiology / Q000517:prevention & control; D007431:Intraoperative Complications / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D017063:Outcome Assessment, Health Care; D061226:Recurrent Laryngeal Nerve Injuries / Q000209:etiology / Q000517:prevention & control; D015203:Reproducibility of Results; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D014481:United States; D020535:Video-Assisted Surgery / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data
keywords: endoscopic; minimally invasive; minimally invasive video-assisted thyroidectomy (MIVAT); thyroidectomy