Minimally Invasive Video-Assisted Thyroidectomy: Analysis of Complications From a Systematic Review

Abstract

Background. Nowadays, minimally invasive video-assisted thyroidectomy (MIVAT) is considered a safe and effective option. However, its complication rate has not been specifically discussed yet. The aim of this systematic review was enrolling a large number of studies to estimate early and late complications (transient and definitive, uni-and bilateral laryngeal nerve palsy; transient and definitive hypocalcemia; cervical hematoma; hypertrophic or keloid scar) of MIVAT compared with conventional technique. Methods. The review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria in PubMed and Embase. Search terms were "minimally invasive," "video-assisted," and "thyroidectomy." We enrolled randomized clinical trials, nonrandomized trials, and noncontrolled trials. Results. Thirty-two articles were considered suitable. Complication rate of MIVAT was quite similar to conventional technique: only one randomized trial found a significant difference concerning overall skin complication, and a single trial highlighted hypocalcemia significantly increased in MIVAT, concerning serologic value only. No difference concerning symptomatic nor definitive hypocalcemia was found. Conclusions. We can confirm that MIVAT is a safe technique. It should be adopted in mean-high-volume surgery centers for thyroidectomy, if a strict compliance with indication was applied.

Better Outcomes With Minimally Invasive Thyroidectomy Than Conventional Thyroidectomy

“…It is even more pronounced when a new technique is proposed alternative to centuries old one such as thyroidectomy. In our case, different studies reveal that minimally invasive thyroidectomy results in statistically similar postoperative complications such as hypocalcemia, vocal cord paralysis [2,14,16,17]. When our study is concerned, although minimally invasive group has less postoperative complications; no statistical difference in occurrence of hypocalcemia and vocal cord paralysis between the conventional group and minimally invasive group were seen.…”

“…With robotic thyroid surgery still progressing, many centers with conventional surgical setups are suitable for minimally invasive procedures and with little added instruments to their armamentaria, the surgeries can be performed without more effort. In the literature, minimally invasive thyroidectomies are favored for their lower postoperative pain, higher cosmetic outcomes and equal surgical safety and better visualization of thyroid vessels and recurrent laryngeal nerves [12][13][14] .…”

Papillary Thyroid Microcarcinoma: Active Surveillance Against Surgery. Considerations of an Italian Working Group From a Systematic Review

“…These considerations are further confirmed by the fact that thyroidectomy can now be performed effectively using minimally invasive techniques ( 37 ).…”

Recent Trends in Surgical Approach to Thyroid Cancer

“…Since its introduction in the late 1990s, MIVAT has been worldwide adopted thanks to its reproducibility and its comparable outcomes to the conventional open approach. This minimally invasive video-assisted technique permits surgeons to safely perform thyroidectomy and provides the benefits of the typical advantages proper of endoscopic surgery, including magnified vision, better cosmetic results, and reduced postoperative pain ( 9 , 10 ).…”