Minimally invasive compared with conventional thyroidectomy for nodular goitre.

Area of Science:

• Endocrine Surgery
• Surgical Oncology

Background:

• Minimally invasive thyroidectomy (MIT) approaches emerged in 1997.
• Various MIT techniques include minimal neck incision and extracervical access (chest, axillary).
• Conventional open thyroidectomy (COT) is versatile for all thyroid conditions.

Purpose of the Study:

• To compare the efficacy and safety of different thyroidectomy approaches.
• To evaluate cosmesis, postoperative pain, and surgical morbidity.
• To determine the gold standard for nodular goiter treatment.

Main Methods:

• Systematic review of 11 prospective randomized studies and 6 systematic reviews.
• Comparison of minimally invasive video-assisted thyroidectomy (MIVAT) with COT.
• Analysis of extracervical scarless neck thyroidectomy (ESNT) versus COT and MIT.

Main Results:

• MIVAT showed better short-term cosmesis and reduced pain compared to COT.
• Surgical morbidity was comparable between MIVAT and COT in limited studies.
• ESNT was associated with increased pain and unique complications compared to MIT and COT.

Conclusions:

• COT remains the gold standard for nodular goiter due to its broad applicability.
• MIVAT offers cosmetic advantages and reduced pain for select cases.
• ESNT presents significant drawbacks and lacks comparative evidence against COT.