Minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study

Abstract
Background  Since the first description of the minimally invasive totally gasless video-assisted thyroidectomy (MIVAT) technique in 1998,
relatively few studies have evaluated the outcome of this procedure. The authors review their experiences based on a prospective
randomized trial comparing the potential advantages of MIVAT over conventional thyroidectomy.

Methods  Patients undergoing surgery for either thyroid nodule or diffuse thyroid disease with hyperthyroidism were randomly selected
for either MIVAT or conventional thyroidectomy. The exclusion criteria specified nodules larger than 35 mm, thyroid lobe volume
greater than 20 ml, thyroiditis, and previous neck irradiation or surgery. Operative time, postoperative complications, and
cosmetic results were evaluated using both a verbal response scale and a numeric scale.

Results  Both the MIVAT group and the conventional thyroidectomy group included 15 patients. No significant differences were noted
between the two groups in terms of age, sex, or indication for operation. The mean operative times were 65.5 ± 18 min. for
MIVAT and 43.3 ± 14 min. for conventional thyroidectomy (P = 0.001). No postoperative complications were detected in either group. The cosmetic results, evaluated by both verbal response
and numeric scales, were respectively as follows: MIVAT (3.7 ± 0.2 and 7.9 ± 1.2) and conventional thyroidectomy (2.3 ± 0.7
and 4.9 ± 1.3). The differences significantly favored MIVAT (P = 0.028 and P = 0.015, respectively) despite the small number of patients enrolled in this study, and consequently, its limited statistical
power.

Conclusion  Although the complications are comparable between the two approaches, conventional thyroidectomy involves less operative time.
However, MIVAT offers distinct advantages to selected patients in terms of very good to exellent cosmetic results and reduced
postoperative distress.

Content Type Journal ArticleCategory Original PaperDOI 10.1007/s00464-008-9806-2Authors
Istvan Gal, Bugat Pal University Hospital Department of Surgery Dozsa Gyorgy u. 20-22 3200 Gyongyos HungaryTamas Solymosi, Bugat Pal University Hospital Department of Surgery Dozsa Gyorgy u. 20-22 3200 Gyongyos HungaryZoltan Szabo, Microsurgery and Operative Endoscopy Training (MOET) Institute San Francisco CA USAAlexander Balint, Bugat Pal University Hospital Department of Surgery Dozsa Gyorgy u. 20-22 3200 Gyongyos HungaryGyorgy Bolgar, Bugat Pal University Hospital Department of Surgery Dozsa Gyorgy u. 20-22 3200 Gyongyos Hungary

Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794 (Source: Surgical Endoscopy)