Video-assisted thyroidectomy: report on the experience of a single center in more than four hundred cases
| Autor: | Carmela De Crea, Celestino Pio Lombardi, Marco Raffaelli, Rocco Domenico Alfonso Bellantone, Pietro Princi |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Settore MED/18 - CHIRURGIA GENERALE Video-Assisted Surgery Single Center Video-assisted thyroidectmy parasitic diseases Medicine Humans Thyroid Neoplasms Child Minimally invasive thyroidectomy Aged business.industry General surgery Thyroidectomy nutritional and metabolic diseases Middle Aged Thyroid Diseases Thyroid surgery Surgery Video assisted thyroidectomy Lymph Node Excision Female business human activities tissues Neck |
| Zdroj: | World journal of surgery. 30(5) |
| ISSN: | 0364-2313 |
| Popis: | We report on our series of patients selected for video-assisted thyroidectomy (VAT) over a 7-year period and discuss the results obtained.Video-assisted thyroidectomy is a gasless procedure performed under endoscopic vision through a single 1.5-2.0-cm skin incision, using a technique very similar to conventional surgery. Eligibility criteria were these: thyroid nodules35 mm; thyroid volume30 ml; no previous conventional neck surgery. Small, low-risk, papillary thyroid carcinomas (PTC) were considered eligible.A total of 473 VATs were attempted on 459 patients. Locoregional anesthesia was used in 15 patients. Conversion was necessary in 6 (difficult dissection in 1 case, large nodule size in 3, gross lymph node metastases in 2). Thyroid lobectomy was successfully performed in 110 cases, total thyroidectomy in 343, and completion thyroidectomy in 14. In 66 patients with carcinoma, central neck nodes were removed through the same access. Concomitant parathyroidectomy was performed in 14 patients. Pathology showed benign disease in 277 cases, PTC in 175, and medullary microcarcinoma in 1. Postoperative complications included 8 transient recurrent nerve palsies, 64 transient hypocalcemias, 3 definitive hypocalcemias, 1 postoperative hematoma, and 2 wound infections. Postoperative pain was minimal and the cosmetic result excellent. In patients with PTC no evidence of recurrent or residual disease was shown.Indications for VAT are still limited (20% of patients who require thyroidectomy). Nonetheless, in selected patients, it seems a valid option for thyroidectomy and it could be considered even preferable to conventional surgery because of its significant advantages, especially in terms of cosmetic result. |
| Databáze: | OpenAIRE |
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