Video-assisted thyroidectomy for Graves? disease: report of a preliminary experience

Berti, Piero; Materazzi, Gabriele; Galleri, David; Donatini, Gianluca; Minuto, Michele; Miccoli, Paolo

doi:10.1007/s00464-003-9225-3

Cited by 45 publications

(26 citation statements)

References 14 publications

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“…The results in the study remained the same, even with longer operative time. The rate of infection is also comparable to other endoscopic techniques (15)(16)(17)(18).…”

Section: Discussionsupporting

confidence: 64%

“…At present, there is little data on the use of endoscopic or robotic thyroidectomy in Graves' disease patients (15)(16)(17)(18), possibly because of hypervascularity and the large size of the thyroid gland in these patients. Moreover, there is no report for use of the transoral thyroidectomy in Graves' disease patients either.…”

Section: Discussionmentioning

confidence: 99%

“…The enhanced refinement of this transoral thyroidectomy technique was well-established and described by Anuwong as the transoral endoscopic thyroidectomy vestibular approach (TOETVA) with excellent clinical results (14). This successful experience with TOETVA led the authors of this paper to extend the indications for the procedure to include patients with Graves' disease, for which there remains little data concerning the use of endoscopic thyroidectomy approaches (15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

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Transoral endoscopic thyroidectomy vestibular approach (TOETVA) for Graves’ disease: a comparison of surgical results with open thyroidectomy

et al. 2016

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Background: Transoral endoscopic thyroidectomy vestibular approach (TOETVA) provides excellent cosmetic results from its potential for scar-free operation. The procedure has been applied successfully for Graves' disease by the authors of this work and compared with the standard open cervical approach to evaluate its safety and outcomes.Methods: From January 2014 to November 2016, a total of 97 patients with Graves' disease were reviewed retrospectively. Open thyroidectomy (OT) and TOETVA were performed in 49 patients and 46 patients, respectively. For TOETVA, a three-port technique through the oral vestibule was utilized. The thyroidectomy was done endoscopically using conventional laparoscopic instruments and an ultrasonic device. Patient demographics and surgical variables, including operative time, blood loss, and complications, were investigated and compared.Results: TOETVA was performed successfully in all 45 patients, although conversion to open surgery was deemed necessary in one patient. All patient characteristics for both groups were similar. Operative time was shorter for the OT group compared to the TOETVA group, which totaled 101.97±24.618 and 134.11±31.48 minutes, respectively (P<<0.5). Blood loss was comparable for both groups. The visual analog scale (VAS) pain score for the TOETVA group was significantly lower than for the OT group on day 1 (2.08±1.53 vs. 4.57±1.35), day 2 (0.84±1.12 vs. 2.57±1.08) and day 3 (0.33±0.71 vs. 1.08±1.01) (P<<0.05).Transient recurrent laryngeal nerve (RLN) palsy was found in four and two cases of TOETVA and OT group, respectively. Transient hypocalcemia was found in ten and seven cases of TOETVA and OT group, respectively. No other complications were observed.Conclusions: TOETVA is a feasible and safe treatment for Graves' disease in comparison to the standard open cervical approach. It is considered a viable alternative for patients who have been indicated for surgery with excellent cosmetic results.

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“…The results in the study remained the same, even with longer operative time. The rate of infection is also comparable to other endoscopic techniques (15)(16)(17)(18).…”

Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Transoral endoscopic thyroidectomy vestibular approach (TOETVA) for Graves’ disease: a comparison of surgical results with open thyroidectomy

et al. 2016

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“…24 Although minimally invasive surgery has been used to treat several types of thyroid disorders, the increased gland vascularity in toxic diffuse goiter was first considered a relative contraindication to the minimally invasive approach because of the potential technical difficulty and thus the high incidence of complications in the presence of bleeding. However, Berti and colleagues in 2004, 17 Maeda and colleagues in 2006, 25 and, more recently, Alesina and colleagues in 2011 26 have demonstrated that VAT is feasible and safe for the treatment of Graves' disease, with results equivalent to those of conventional open surgery. The minimal length of surgical incision (1.5-3 cm) is a key advantage of VAT in comparison with conventional thyroidectomy but at the same time is the main limitation of this type of surgery.…”

Section: Discussionmentioning

confidence: 99%

“…This is mainly due to increased glandular vascularity and frequent periglandular inflammation, resulting in potential technical difficulties and an increased incidence of complications. 17 The aim of this study was to compare the efficacy and safety of open, nonendoscopic minimal-incision thyroidectomy with that of conventional thyroidectomy in the treatment of patients with Graves' disease.…”

Section: Introductionmentioning

confidence: 99%

Feasibility and safety of minimal‐incision thyroidectomy for Graves' disease: A prospective, single‐center study

et al. 2012

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Background. The role of minimally invasive surgery in Graves' disease is still controversial. The aim of this study was to compare the clinical outcomes of patients undergoing minimal-incision thyroidectomy with those undergoing conventional thyroidectomy for Graves' disease. Methods. A prospective study was performed on 148 patients undergoing total thyroidectomy. Seventy-one patients underwent minimal-incision thyroidectomy and 77 underwent conventional thyroidectomy. Minimal-incision thyroidectomy was proposed if the thyroid volume was 50 mL.Results. There were no significant differences in the operative time between minimal-incision thyroidectomy and conventional thyroidectomy. The length of skin incision was significantly shorter in the minimal-incision thyroidectomy than that in the conventional thyroidectomy group. The incidence of postoperative complications was similar in the 2 groups. Patients undergoing minimal-incision thyroidectomy experienced significantly less postoperative pain and were more satisfied with the cosmetic result than patients who underwent conventional thyroidectomy. Conclusions. Minimal-incision thyroidectomy is a feasible and safe option for the surgical treatment of selected patients with Graves' disease.

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Video-assisted subtotal or near-total thyroidectomy for Graves' disease

Maeda

Uga

Hayashida

et al. 2006

Journal of British Surgery

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Video-assisted thyroidectomy for Graves? disease: report of a preliminary experience

Abstract: Graves' disease can be treated safely using VAT only if selection criteria are carefully respected. The young age of the patients with this disease encourages us to propose VAT for its good cosmetic and postoperative outcome.

Cited by 45 publications

References 14 publications

Transoral endoscopic thyroidectomy vestibular approach (TOETVA) for Graves’ disease: a comparison of surgical results with open thyroidectomy

Transoral endoscopic thyroidectomy vestibular approach (TOETVA) for Graves’ disease: a comparison of surgical results with open thyroidectomy

Feasibility and safety of minimal‐incision thyroidectomy for Graves' disease: A prospective, single‐center study

Video-assisted subtotal or near-total thyroidectomy for Graves' disease

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