Comparison between minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prospective...

Area of Science:

• Endocrinology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Endoscopic thyroid surgery introduced in 1998, but limited adoption due to unproven benefits.
• Conventional thyroidectomy (CT) remains standard, but minimally invasive techniques are emerging.
• Need for comparative studies to validate advantages of endoscopic approaches.

Purpose of the Study:

• To compare minimally invasive video-assisted thyroidectomy (MIVAT) with conventional thyroidectomy (CT).
• To evaluate operative time, postoperative pain, complications, and cosmetic outcomes.
• To assess the feasibility and potential benefits of MIVAT for specific thyroid conditions.

Main Methods:

• Prospective study of 49 patients with thyroid nodules or small papillary carcinoma.
• Patients randomized to MIVAT or CT, with specific exclusion criteria.
• Standardized assessment of operative time, pain, complications, and cosmetic results.

Main Results:

• MIVAT (25 patients) showed significantly less postoperative pain (P=.003) and better cosmetic results (P=.003, P=.01).
• Conventional thyroidectomy (24 patients) had a shorter operative time (45 vs. 66 minutes, P=.001).
• Complication rates were comparable, with transient nerve palsy and hypoparathyroidism noted in both groups.

Conclusions:

• MIVAT demonstrates advantages in reduced postoperative pain and improved cosmesis.
• Conventional thyroidectomy retains an advantage in operative time and comparable safety.
• Larger patient cohorts are required to definitively establish the superiority of endoscopic thyroidectomy.