Minimally invasive thyroidectomy: a ten years experience.
BACKGROUND
The conventional thyroidectomy is the most frequent surgical procedure for thyroidal surgical disease. From several years were introduced minimally invasive approaches to thyroid surgery. These new procedures improved the incidence of postoperative pain, cosmetic results, patient's quality of life, postoperative morbidity. The mini invasive video-assisted thyroidectomy (MIVAT) is a minimally invasive procedure that uses a minicervicotomy to treat thyroidal diseases.


METHODS
We present our experience on 497 consecutively treated patients with MIVAT technique. We analyzed the mean age, sex, mean operative time, rate of bleeding, hypocalcemia, transitory and definitive nerve palsy (6 months after the procedure), postoperative pain scale from 0 to 10 at 1 hour and 24 hours after surgery, mean hospital stay.


RESULTS
The indications to treat were related to preoperative diagnosis: 182 THYR 6, 184 THYR 3-4, 27 plummer, 24 basedow, 28 toxic goiter, 52 goiter. On 497 cases we have reported 1 case of bleeding (0,2%), 12 (2,4%) cases of transitory nerve palsy and 4 (0,8%) definitive nerve palsy. The rate of serologic hypocalcemia was 24.9% (124 cases) and clinical in 7.2% (36 cases); 1 case of hypoparathyroidism (0.2%).


CONCLUSIONS
The MIVAT is a safe approach to surgical thyroid disease, the cost are similar to CT as the adverse events. The minicervicotomy is really a minimally invasive tissue dissection.
Unit of general Surgery and Organ Transplantation, University Hospital of Parma, Parma, Italy.
Paolo
P
Del Rio
Unit of general Surgery and Organ Transplantation, University Hospital of Parma, Parma, Italy.
Lorenzo
L
Viani
Unit of general Surgery and Organ Transplantation, University Hospital of Parma, Parma, Italy.
Chiara Montana
CM
Montana
Unit of general Surgery and Organ Transplantation, University Hospital of Parma, Parma, Italy.
Federico
F
Cozzani
Unit of general Surgery and Organ Transplantation, University Hospital of Parma, Parma, Italy.
Mario
M
Sianesi
Thyroidectomy; minimally invasive thyroidectomy; neuromonitoring; thyroid carcinoma