Current surgical status of thyroid diseases

Abstract

Thyroid nodules are a common clinical problem for surgeons. The clinical importance of nodules is the need to exclude thyroid cancer, which occurs in 5%–15% of patients. If fine needle aspiration cytology is positive, or suspicious for malignancy, surgery is recommended. During the past decade, with the tendency to develop smaller incisions, an endoscopic approach has been applied to thyroid surgery, called minimally invasive video-assisted thyroidectomy. This approach was immediately followed by other minimally invasive or scarless neck techniques, such as the breast approach, axillary-breast approach, and robot-assisted method. All these techniques follow the same principles of surgery and oncology. This review presents the current surgical management of the thyroid gland, including the surgical techniques and compares them by describing benefits and drawbacks of each one.

Minimally Invasive Video-Assisted versus Minimally Invasive Nonendoscopic Thyroidectomy

“…Common goal of minimally invasive approaches is better cosmetic results, decreased postoperative pain, and shortening of inpatient period, without an increase in the postoperative complication rates [ 13 ]. To achieve these demands it is useful to abide strict indication criteria.…”

“…Different approach to the thyroid gland was explored in Japan, where Ikeda et al developed endoscopic approach via axillary incision [ 15 ]. Since then, many modifications of these so-called extracervical approaches were developed (see review by Touzopoulos et al [ 13 ]). Development in robotic surgery facilitated introduction of novel approaches, such as transoral video-assisted thyroidectomy (TOVAT) or retroauricular approach (RA) [ 16 , 17 ].…”