Minimally Invasive Video‐Assisted Thyroidectomy for Benign Thyroid Disease: An Evidence‐Based Review

Miccoli, Paolo; Minuto, Michele; Ugolini, Clara; Pisano, Roberta; Fosso, Alessandra; Berti, Piero

doi:10.1007/s00268-008-9479-y

Cited by 119 publications

(89 citation statements)

References 53 publications

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“…The rate of conversion to open has been reported at 0-13% 21 the main reasons for conversion to open surgery are hemorrhage, difficult dissection, tumor size, thyroiditis and tracheal injury [21]. In present study, four patients were required conversion to open because of bleeding from surface of nodule and from the superior thyroid vessels.…”

Section: Journal Of Universal Surgery Issn 2254-6758mentioning

confidence: 80%

Endoscopic Thyroidectomy: Experience of Breast and Axillary Approach

Ch¹,

Mishra²,

Kumar³

et al. 2017

J Univer Surg

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Section: Journal Of Universal Surgery Issn 2254-6758mentioning

confidence: 80%

Endoscopic Thyroidectomy: Experience of Breast and Axillary Approach

Ch¹,

Mishra²,

Kumar³

et al. 2017

J Univer Surg

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“…[6][7][8]10,11 Previous meta-analyses based on these RCTs have reiterated the cosmetic advantage of MIVAT over CT [26][27][28][29] but the abovementioned heterogeneity in wound closure, timing of scar assessment, variety and lack of validation of assessment tools should be borne in mind when interpreting these results. One review article 30 acknowledged this, limiting its meta-analysis of 3/5 RCTs.…”

Section: Randomised Controlled Trialsmentioning

confidence: 99%

“…26 An open incision for a small gland/thyroid nodule need not be 6-8cm although this is commonly cited by advocates of MIVAT. 20 Table 1 shows the postoperative length of minimally invasive and conventional cervicotomy scars.…”

Section: Incision Length and Cosmesismentioning

confidence: 99%

Short and long-term cosmesis of cervical thyroidectomy scars

Dordea

Aspinall

2016

annals

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INTRODUCTION Multiple surgical approaches to the thyroid gland have been described via cervical or extracervical routes. Improved cosmesis, patient satisfaction, reduced pain (procedure dependent) and early discharge have all been reported for minimally invasive approaches with similar safety profiles and long-term outcomes to conventional surgery. This review summarises the current evidence base for improved cosmesis with minimally invasive cervical approaches to the thyroid gland compared with conventional surgery. METHODS A systematic review was undertaken. The MEDLINE ® , Embase™ and Cochrane databases were searched for relevant articles. RESULTS A total of 57 papers thyroid papers were identified. Of those, 20 reported some form of cosmetic outcome assessment. There were 6 randomised controlled trials with 412 patients (evidence level 2B), 7 cohort studies with 3,073 patients (level 3B) and 7 non-comparative case series with 1,575 patients (level 4). There was significant heterogeneity between studies in terms of wound closure technique, timing of scar assessment and scar assessment scales (validated and non-validated). Most studies performed early scar assessments, some using non-validated scar assessment tools. CONCLUSIONS Assessment of cosmesis is complex and requires rigorous methodology. Evidence from healing/remodelling studies suggests scar maturation is a long-term process. This calls into question the value of early scar assessment. Current evidence does not support minimally invasive surgical approaches to the thyroid gland if improved long-term cosmesis is the goal. KEYWORDSThyroidectomy -Minimally invasive video assisted thyroidectomy -Scar -Cosmesis

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“…13,19,[41][42][43][44][45][46] One of the reasons for this initial refusal is partly due to the technical difficulty of endoscopic resection, which requires adequate training both in open and endoscopic procedures before gland resection can be safely performed. 46 MIVAT has the potential to offer similar advantages over conventional thyroidectomy.…”

Section: Dovepressmentioning

confidence: 99%

Comparison of minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a single-blinded, randomized controlled clinical trial

Ellabban¹

2010

OAS

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Aim:We aimed to test the hypothesis that minimally invasive video-assisted thyroidectomy (MIVAT) affords comparable safety and efficacy as open conventional surgery in patients with unilateral thyroid nodules or follicular lesions in terms of cosmetic results, intraoperative and postoperative complications, postoperative pain, and hospital stay. Methods: A single-blinded randomized controlled trial compared MIVAT with conventional thyroidectomy. The primary endpoints of the study were measurement of postoperative pain after 24 and 48 hours and cosmetic outcome 3 months postoperatively. The secondary outcome measures were operative time, incidence of recurrent laryngeal nerve injury, length of incision, and hospital stay. Results: Operative time was less with open thyroidectomy than with MIVAT, while MIVAT was associated with less pain 24 hours postoperatively. Pain score showed statistically significant differences in favor of MIVAT after 24 hours. MIVAT was associated with less scarring and more satisfaction with cosmetic results. There was no difference between both procedures for presence of transient recurrent laryngeal nerve palsy and hypoparathyroidism. Conclusion: MIVAT is a safe procedure that produces outcomes similar to those of open thyroidectomy, and is superior in terms of immediate postoperative pain and cosmetic results

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Minimally Invasive Video‐Assisted Thyroidectomy for Benign Thyroid Disease: An Evidence‐Based Review

Abstract: In spite of an increasing trend toward performing more extensive procedures other than thyroidectomy alone during videoscopic procedures, the current literature seems to reaffirm that the main and safest indication for MIVAT is benign disease.

Cited by 119 publications

References 53 publications

Endoscopic Thyroidectomy: Experience of Breast and Axillary Approach

Endoscopic Thyroidectomy: Experience of Breast and Axillary Approach

Short and long-term cosmesis of cervical thyroidectomy scars

Comparison of minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a single-blinded, randomized controlled clinical trial

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