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Video-assisted open thyroid lobectomy through a small incision.

Tzu-Chieh Chao1, Jen-Der Lin, Miin-Fu Chen

  • 1Department of Surgery, Chang Gung University College of Medicine, and Chang Gung Memorial Hospital, Taoyuan, Taiwan. tcchao@adm.cgmh.org.tw

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
|July 21, 2004
PubMed
Summary

Gasless video-assisted thyroid lobectomy showed reduced external branch of the superior laryngeal nerve injury compared to conventional surgery. However, both methods had similar rates of transient recurrent laryngeal nerve palsy, indicating potential morbidity in the minimally invasive approach.

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Minimally Invasive Surgery

Background:

  • Thyroid lobectomy is a common procedure for solitary nodules.
  • Gasless video-assisted thyroid lobectomy (GVATL) offers potential benefits but requires evaluation for safety and efficacy.
  • Postoperative morbidity is a key concern in all surgical interventions.

Purpose of the Study:

  • To compare the postoperative morbidity between gasless video-assisted thyroid lobectomy (GVATL) and conventional thyroid lobectomy.
  • To assess the incidence of specific complications, including nerve injury, in both surgical techniques.

Main Methods:

  • A comparative study involving 111 patients with solitary thyroid nodules.
  • Patients were randomized to either GVATL or conventional lobectomy.

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  • Outcomes measured included operating time, mortality, hemorrhage, infection, and recurrent laryngeal nerve (RLN) and external branch of the superior laryngeal nerve (EBSLN) injury.

    • Main Results:

    • GVATL required significantly longer operating times than conventional surgery.
    • No deaths, massive hemorrhage, wound hematoma, wound infection, or permanent RLN injury were observed in either group.
    • Damage to the EBSLN occurred in 10.2% of conventional surgery patients versus 0% in GVATL patients (P = .0289).
    • Transient RLN palsy rates were similar: 8.5% for conventional and 5.8% for GVATL (P = .7209).

    Conclusions:

    • Gasless video-assisted thyroid lobectomy demonstrates a significant advantage in preventing external branch of the superior laryngeal nerve injury.
    • While GVATL shows promise, it is associated with longer operating times and potential for other morbidities.
    • Adherence to fundamental thyroid surgery principles is crucial for minimizing complications in GVATL.