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Scerrino G, Melfa G, Raspanti C, Rotolo G, Salamone G, Licari L, Fontana T, Tutino R, Porrello C, Gulotta G, Cocorullo G. Minimally Invasive Video-Assisted Thyroidectomy: Analysis of Complications From a Systematic Review. Surg Innov 2019; 26:381-387. [PMID: 30632464 DOI: 10.1177/1553350618823425] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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.
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Neagoe RM, Cvasciuc IT, Muresan M, Sala DT. INCIDENTAL PARATHYROIDECTOMY DURING THYROID SURGERY - RISK, PREVENTION AND CONTROVERSIES; AN EVIDENCE-BASED REVIEW. ACTA ENDOCRINOLOGICA-BUCHAREST 2017; 13:467-475. [PMID: 31149218 DOI: 10.4183/aeb.2017.467] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background Postoperative hypocalcemia after thyroid surgery has a high prevalence ( 16-55% in different series). Incidental parathyroidectomy (IP) is a less discussed complication of thyroidectomy with consequences not properly defined. The aim of our study was to find incidence, risk factors and how to prevent IP. Methods Extensive search of English literature publications via PubMed was performed and 73 papers from 1980 to 2017 were analysed using the GRADE system/classification, quality of evidence was classified as "strong" when the result is highly unlikely to change existing recommendation and "weak" when opposite. Results Incidence of IP is 3.7-24.9%, while prevalence of permanent hypoparathyroidism is less frequent 6-12%. Direct relation between IP and hypoparathyroidism/hypocalcemia remains controversial. Female patients, ectopic parathyroids, small thyroids, Graves', malignancy, redo surgeries and total thyroidectomy favour IP. Routine visualization of parathyroids, new hemostatic devices, magnifying instruments and fluorescence can prevent incidental removal of parathyroids. Incidence of IP during videoassisted or robotic thyroidectomies was similar to open procedures. High volume, experienced and younger surgeons have lower complication rates (including hypoparathyroidism). Conclusions Incidental parathyroidectomy is more frequent than we might have expected. It should be avoided and parathyroid glands should be kept in situ. Majority of studies are retrospective (low degree of evidence according to previous mentioned GRADE classification) and further meta-analysis or randomized control studies are welcome in order to define the impact of incidental removal of parathyroids on postoperative outcome.
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Affiliation(s)
- R M Neagoe
- University of Medicine and Pharmacy, Second Department of Surgery, Targu Mures, Romania
| | - I T Cvasciuc
- Leeds Teaching Hospitals, Dept. of Endocrine Surgery, Leeds, United Kingdom of Great Britain and Northern Ireland
| | - M Muresan
- University of Medicine and Pharmacy, General Surgery, Targu Mures, Romania
| | - D T Sala
- Emergency Mures County Hospital, Second Department of Surgery, Targu Mures, Romania
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Best AR, Shipchandler TZ, Cordes SR. Midcervical scar satisfaction in thyroidectomy patients. Laryngoscope 2016; 127:1247-1252. [PMID: 27519726 DOI: 10.1002/lary.26177] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 02/19/2016] [Accepted: 06/09/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS Assess long-term patient satisfaction with conventional thyroidectomy scars and the impact of thyroidectomy scars on patient quality of life. STUDY DESIGN Validated survey administration and retrospective review of clinical and demographic data. METHODS Patients who underwent conventional thyroidectomy through years 2000 to 2010 were identified and administered the validated Patient Scar Assessment Questionnaire. Mean satisfaction, appearance and scar-consciousness scores were determined. Thirty-seven patients also measured the length of their current scar. Patient demographic and operative data were collected retrospectively from the medical record. Data were analyzed with one-way analysis of variance and independent samples t testing. RESULTS Sixty of 69 patients perceived the appearance of their scar to be "good" or "excellent." Sixty-three patients (91.3%) were satisfied with all scar outcomes; 67 (97.1%) were satisfied with the overall appearance of their scar. Mean total satisfaction score was 17.3 (<26 indicates a high level of satisfaction). Fifty-six (81.2%) were "not at all" self-conscious of their scar; 65 (94.2%) reported no attempt to hide their scar. Seven patients (10.1%) indicated any likelihood of pursuing scar revision. Females had significantly higher total satisfaction scores, consciousness scores, and satisfaction with appearance scores. The effect of perceived scar length was significant for scar-consciousness, not patient satisfaction. CONCLUSIONS The majority of patients were satisfied with their thyroidectomy scar appearance. Few patients reported a desire to hide the scar or pursue revision. Women were more likely to be dissatisfied than men. Length may play a role in scar consciousness. LEVEL OF EVIDENCE 4 Laryngoscope, 127:1247-1252, 2017.
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Affiliation(s)
- Amy R Best
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A
| | - Taha Z Shipchandler
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A
| | - Susan R Cordes
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A
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Bakkar S, Materazzi G, Biricotti M, De Napoli L, Conte M, Galleri D, Aghababyan A, Miccoli P. Minimally invasive video-assisted thyroidectomy (MIVAT) from A to Z. Surg Today 2015; 46:255-9. [PMID: 26321206 DOI: 10.1007/s00595-015-1241-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Accepted: 08/09/2015] [Indexed: 10/23/2022]
Abstract
A minimal access procedure does not necessarily mean that it is minimally invasive. However, as its name implies, MIVAT is a truly minimally invasive treatment modality. The advantages it offers over its conventional counterpart are indeed related to its minimally invasive nature. Furthermore, this nature has not compromised its ability to accomplish its purpose both safely and effectively. Ever since its introduction in the late 1990s, MIVAT has been progressively evolving. The indications for this procedure, which was initially surrounded by skepticism, have been expanding. Benign thyroid pathology is now considered only one of its indications among others. This article provides a detailed description of this minimally invasive, maximally effective and patient satisfying procedure so that it may be adopted by more surgeons around the globe for better patient care and to also encourage the development of further future advancements.
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Affiliation(s)
- Sohail Bakkar
- Department of Surgery, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
| | - Gabriele Materazzi
- Department of Surgery, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - Marco Biricotti
- Department of Surgery, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - Luigi De Napoli
- Department of Surgery, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - Massimo Conte
- Department of Surgery, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - David Galleri
- Department of Surgery, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - Aleksandr Aghababyan
- Department of Surgery, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - Paolo Miccoli
- Department of Surgery, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy
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Piniek A, Schuhmann R, Coerper S. [Minimally invasive video-assisted thyroidectomy: establishment in a thyroid center]. Chirurg 2014; 85:246-52. [PMID: 24218083 DOI: 10.1007/s00104-013-2624-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND This study retrospectively evaluated a series of patients who underwent minimally invasive video-assisted thyroidectomy (MIVAT) during the introduction stage of this surgical technique at the Martha-Maria Hospital in Nuremberg. PATIENTS AND METHODS The eligibility criteria for MIVAT were a thyroid volume < 25 ml, nodules < 30 mm, no thyroiditis, no preoperative evidence of carcinoma and no previous neck surgery. A retrospective evaluation was performed together with a control group of patients who underwent conventional thyroid surgery during the same time period and included a follow-up for general patient satisfaction and cosmetic results. RESULTS Between August 2008 and July 2009 a total of 55 patients underwent MIVAT including 8 conversions to open surgery and 45 patients who underwent conventional surgery served as matched controls. No significant differences in terms of perioperative complication rates were found (e.g. recurrent laryngeal nerve palsy, hypocalcemia or secondary hemorrhage). The mean operating time was significantly longer in the MIVAT group (96.8 ± 3.7 min vs. 69.8 ± 2.3 min, p = 0.001) whereas a significant decrease in the mean operating time for hemithyroidectomy after 5 months was observed (98.1 ± 3.77 min vs. 76.0 ± 4.98 min, p = 0.013). Patients in the MIVAT group were more satisfied with the cosmetic outcome (8.5 ± 0.3 vs. 8.2 ± 0.2, p = 0.05) as well as with the overall surgical procedure (9.0 ± 0.3 vs. 8.6 ± 0.2, p = 0.02). CONCLUSION During introduction of the MIVAT procedure a learning effect can be observed which is hallmarked by a decrease in operating time and conversion rate to open surgery. Moreover, no significant differences in terms of main postoperative complications were found so that MIVAT can be considered a safe and feasible technique under the conditions of correct eligibility criteria.
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Affiliation(s)
- A Piniek
- Chirurgisches Schilddrüsen- und Nebenschilddrüsenzentrum, Klinik für Allgemein-, Visceral- und Gefäßchirurgie, Krankenhaus Martha-Maria, Stadenstr. 58, 90491, Nürnberg, Deutschland,
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Jeong JJ, Kim KH, Koh YW, Nam KH, Chung WY, Park CS. Surgical completeness of total thyroidectomy using harmonic scalpel: comparison with conventional total thyroidectomy in papillary thyroid carcinoma patients. JOURNAL OF THE KOREAN SURGICAL SOCIETY 2012; 83:267-73. [PMID: 23166885 PMCID: PMC3491228 DOI: 10.4174/jkss.2012.83.5.267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 08/10/2012] [Accepted: 09/02/2012] [Indexed: 12/04/2022]
Abstract
Purpose The aim of this study was to compare the surgical completeness and outcome of total thyroidectomy in two patient groups: One treated by harmonic scalpel (HS) and one by conventional total thyroidectomy (CT). Methods Between March 2006 and December 2007, 104 patients had total thyroidectomy by HS and 108 patients underwent CT. We analyzed clinicopathological characteristics and stimulated serum thyroid-stimulating hormone (TSH), thyroglobulin (Tg), and anti-Tg antibodies at the time of ablation for both groups. Results Compared with the CT group, the HS group had shorter operating time and hospital stays and reduced postoperative drainage. At postsurgical ablation, mean serum TSH was 80.47 ± 21.77 mU/L in the HS group and 69.74 ± 21.17 mU/L in the CT group, with significant between-group differences (P < 0.001). Mean serum Tg levels after TSH stimulation were 1.57 ± 3.17 and 3.95 ± 10.14 ng/mL in the HS and CT groups, respectively, with significant between-group differences (P = 0.028). Conclusion Total thyroidectomy with an HS is a relatively safe and effective technique for use in patients with PTC. The HS provides surgical completeness and has a beneficial effect on successful ablation.
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Affiliation(s)
- Jong Ju Jeong
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
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Melvin TAN, Eliades SJ, Ha PK, Fakhry C, Saunders JM, Califano JA, Blanco RGF. Neck dissection through a facelift incision. Laryngoscope 2012; 122:2700-6. [PMID: 23023877 DOI: 10.1002/lary.23386] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Revised: 03/03/2012] [Accepted: 04/05/2012] [Indexed: 01/29/2023]
Abstract
OBJECTIVES/HYPOTHESIS To determine the feasibility and safety of neck dissection through a facelift incision. STUDY DESIGN Prospective case series. METHODS Cadavers and live subjects underwent neck dissection using a facelift incision with and without endoscopic assistance. In the live facelift neck dissection (FLND), the preoperative surgical indications, staging, adjuvant therapy, intraoperative technical procedure, pathology reports on lymph nodes, and short-term outcomes were reviewed. RESULTS FLND was successfully performed in four cadavers and four live subjects, including selective (less than five neck levels removed) and comprehensive (levels I-V removed) neck dissections. All levels were accessible through this approach, with additional retraction required for levels I and IV. Endoscopic assistance was required in one neck dissection for adequate visualization. Short-term complications and number of excised lymph nodes were comparable to those from traditional neck dissection approaches. CONCLUSIONS Open neck dissection through a facelift incision is feasible and offers an alternate approach to traditional incisions. This can be performed without requiring robotic assistance and with endoscopic assistance only in certain cases. Endoscopic assistance can offer enhanced visualization of the surgical field and complement open direct approaches in neck dissection. Although FLND offers improved cosmetic outcomes when compared to those of traditional neck incisions, further study is required to determine its efficacy and indications.
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Affiliation(s)
- Thuy-Anh N Melvin
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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Giulianotti PC, Addeo P, Buchs NC, Ayloo SM, Bianco FM. Robotic Thyroidectomy: An Initial Experience with the Gasless Transaxillary Approach. J Laparoendosc Adv Surg Tech A 2012; 22:387-91. [DOI: 10.1089/lap.2010.0380] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Pier Cristoforo Giulianotti
- Division of General, Minimally Invasive, and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois
| | - Pietro Addeo
- Division of General, Minimally Invasive, and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois
| | - Nicolas Christian Buchs
- Division of General, Minimally Invasive, and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois
| | - Subhashini M. Ayloo
- Division of General, Minimally Invasive, and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois
| | - Francesco Maria Bianco
- Division of General, Minimally Invasive, and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois
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Kandil E, Noureldine S, Abdel Khalek M, Aslam R, Ekaidi I, Steiner R, Holsinger FC. Robotic transaxillary thyroidectomy with gasless approach in a girl with goitre. Int J Med Robot 2012; 8:210-4. [DOI: 10.1002/rcs.455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2011] [Indexed: 11/07/2022]
Affiliation(s)
- Emad Kandil
- Department of Surgery, Endocrine and Oncological Surgery Division; Tulane University School of Medicine; New Orleans LA USA
| | - Salem Noureldine
- Department of Surgery, Endocrine and Oncological Surgery Division; Tulane University School of Medicine; New Orleans LA USA
| | - Mohamed Abdel Khalek
- Department of Surgery, Endocrine and Oncological Surgery Division; Tulane University School of Medicine; New Orleans LA USA
| | - Rizwan Aslam
- Department of Otolaryngology; Tulane University School of Medicine; New Orleans LA USA
| | - Ibrahim Ekaidi
- Department of Surgery, Endocrine and Oncological Surgery Division; Tulane University School of Medicine; New Orleans LA USA
| | - Rodney Steiner
- Pediatric Surgery Section; Tulane University School of Medicine; New Orleans LA USA
| | - Floyd C. Holsinger
- Department of Head and Neck Surgery; University of Texas MD Anderson Cancer Center; Houston TX USA
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Kandil E, Noureldine S, Abdel Khalek M, Alrasheedi S, Aslam R, Friedlander P, Holsinger F, Bellows C. Initial experience using robot- assisted transaxillary thyroidectomy for Graves’ disease. J Visc Surg 2011; 148:e447-51. [DOI: 10.1016/j.jviscsurg.2011.10.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Donatini G, Materazzi G, Miccoli P. The endoscopic approach to the neck: a review of the literature and an overview of the various techniques. Surg Endosc 2011; 26:287. [DOI: 10.1007/s00464-011-1875-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Huang XM, Sun W, Zeng L, Liu X, Lu X, Xu YD, Zhang ZG, Xu G. Gasless Endoscopic Thyroidectomy via an Anterior Chest Approach—A Review of 219 Cases with Benign Tumor. World J Surg 2011; 35:1281-6. [DOI: 10.1007/s00268-011-1087-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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13
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Robotic thyroid surgery: need for initial stricter patient selection criteria. Surg Laparosc Endosc Percutan Tech 2011; 19:518; author reply 518-9. [PMID: 20027101 DOI: 10.1097/sle.0b013e3181c4ea0e] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chen ZQ, Wang L, Li T, Hu SY, Zhi XT. Supraclavicular Lateral Collar Incision Versus Conventional Approach for Thyroidectomy: Supplement for Minimally Invasive Techniques with Extended Indications. J Laparoendosc Adv Surg Tech A 2011; 21:45-50. [PMID: 21029025 DOI: 10.1089/lap.2010.0236] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Zhi-qiang Chen
- Minimally Invasive Surgery Centre of Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Wang
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, China
| | - Tao Li
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, China
| | - San-yuan Hu
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, China
| | - Xu-ting Zhi
- Department of General Surgery, Qilu Hospital, Shandong University, Jinan, China
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The endoscopic approach to the neck: a review of the literature, and overview of the various techniques. Surg Endosc 2010; 25:1358-63. [PMID: 21136119 DOI: 10.1007/s00464-010-1452-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Accepted: 09/14/2010] [Indexed: 12/27/2022]
Abstract
BACKGROUND The endoscopic surgical approach to the neck has reached the head and neck surgeons' view with a certain delay, compared to other fields of endoscopic procedures. This may be attributed to the tight work space and plenty of vital structures in the operating field. Since study groups described first attempts with endoscopic or video assisted removals of thyroid glands in the late nineties, selective neck dissections on animal models or cadaveric dissections were performed in 2003. METHOD The review consists of a Medline Search regarding the terms of endoscopic, video- assisted neck dissections, excision of neck lesions, thyroidectomy and submandibular resection and minimal access surgery. The three main procedures (selective neck dissection, submandibular resection and thyroidectomy) are described and reviewed in the following test. RESULTS Various techniques have been performed successfully and led to good clinical results. The studies described in literature other than for thyroidectomy often do not exceed the level of small series or case-reports. CONCLUSION With a good proof of indication gasless lifting techniques, video assisted endoscopical techniques and subcutaneous approaches with gas filling procedures are feasible in neck surgery. All methods depending on the surgeons' experience describe no significantly extended operation times, a better and faster wound-healing and an optimized cosmetic outcome, compared to open approaches. Surgeons should always be aware of the limitations of the minimal invasive techniques regarding the complications or modifications during neck dissection/thyroidectomy.
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Evaluation of postoperative pain after minimally invasive video-assisted and conventional thyroidectomy: results of a prospective study. ESES Vienna presentation. Langenbecks Arch Surg 2010; 395:845-9. [PMID: 20628756 DOI: 10.1007/s00423-010-0688-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2010] [Accepted: 07/05/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND One of the advocated benefits of minimally invasive video-assisted thyroidectomy (MIVAT) is reduction of postoperative pain. We compared in a prospective study pain after video-assisted and conventional thyroidectomy (CT). METHODS One hundred sixty-nine patients (56 men, 113 women, mean age: 50 ± 14 years) operated between November 2007 and February 2008 were included. MIVAT was performed if thyroid volume was <30 ml or the nodule diameter < 35 mm. Postoperative pain scores were documented on a visual analog scale (VAS; 0 = no and 100 = unbearable pain) at 8, 24, 36, and 48 h after surgery. Additionally, postoperative analgesic consumption was registered. RESULTS Seventy-five patients (17 men, 58 women, mean age: 45 ± 15 years) underwent MIVAT and 94 (39 men, 55 women, mean age: 54 ± 15 years) CT. The mean overall VAS score at 8, 24, 36 and 48 h did not significantly differ between the groups (26 ± 21 vs. 26 ± 19 at 8 h, 17 ± 15 vs. 21 ± 18 at 24 h, 11 ± 13 vs. 10 ± 11 at 36 h and 7 ± 12 vs. 6 ± 8 at 48 h in MIVAT and CT group, respectively) [p = ns]. Twelve vs. 13 patients (16% vs. 14%) required opioid administration on the day of the operation [p = ns]. CONCLUSIONS The length of the skin incision seems not to influence the perception of pain after thyroid surgery.
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Current world literature. Curr Opin Otolaryngol Head Neck Surg 2010; 18:134-45. [PMID: 20234215 DOI: 10.1097/moo.0b013e3283383ef9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Fan Y, Guo B, Guo S, Kang J, Wu B, Zhang P, Zheng Q. Minimally invasive video-assisted thyroidectomy: experience of 300 cases. Surg Endosc 2010; 24:2393-400. [DOI: 10.1007/s00464-010-0960-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2009] [Accepted: 01/26/2010] [Indexed: 11/30/2022]
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Abstract
With advances in technology and greater demand for minimally invasive procedures, novel minimally invasive approaches to thyroid and parathyroid glands increasingly have been described and practiced worldwide. For the MIT approaches, the direct/cervical approaches truly can be considered minimally invasive, as they require less surgical dissection than the conventional thyroidectomy. The indirect/extracervical approaches, however, only can be considered endoscopic, however, because they generally do require greater surgical dissection. Still, among the indirect/extracervical approaches, the axillary approach appears the preferred choice, as it requires the least amount of dissection while offering the advantage of being scarless in the neck. The addition of the robot such as the de Vinci surgical system could make some of the extracervical approaches technically less challenging and improve patient outcomes. Unlike MIT, MIP has become the standard approach for surgical management of primary hyperparathyroidism caused by localized solitary parathyroid adenoma.
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Affiliation(s)
- Brian Hung-hin Lang
- Division of Endocrine Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, 102 Pokfulam Road, Pokfulam, Hong Kong SAR, China.
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Selection Criteria for the Oncoplastic Thyroid Surgery Used in Seoul National University Hospital. Surg Laparosc Endosc Percutan Tech 2009. [DOI: 10.1097/sle.0b013e3181c58021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Miccoli P, Materazzi G, Berti P. Natural orifice surgery on the thyroid gland using totally transoral video-assisted thyroidectomy: report of the first experimental results for a new surgical method: are we going in the right direction? Surg Endosc 2009; 24:957-8; author reply 959-60. [DOI: 10.1007/s00464-009-0677-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2009] [Accepted: 07/04/2009] [Indexed: 10/20/2022]
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Kania R, Parodi M, Coste A, Herman P, Tran Ba Huy P, Papon JF. La chirurgie thyroïdienne endoscopique par techniques vidéo-assistées et totalement endoscopiques. ACTA ACUST UNITED AC 2009; 126:82-93. [DOI: 10.1016/j.aorl.2009.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2009] [Accepted: 01/29/2009] [Indexed: 01/10/2023]
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