Minimally invasive video-assisted thyroidectomy (MIVAT) and thyroid cancer: a single centre 10-year follow-up

Thyroid cancer is the most frequent endocrine malignancy, has low recurrence rates and it is particularly common among young women. Minimally invasive video-assisted thyroidectomy (MIVAT), introduced about 25 years ago, is still the most widespread minimally endoscopic procedure. The aim of the study was to obtain long-term follow-up of oncological outcomes and postoperative complications after MIVAT, performed for differentiated thyroid carcinoma.

In our retrospective observational study, we included 81 patients undergone to for differentiated thyroid carcinoma from January 2006 to December 2013 at the General Surgery Clinic of the University Hospital of Parma, Italy. We evaluated anamnesis, preoperative data, type of intervention and eventual conversion to traditional surgery, histological examination, postoperative complications, postoperative radio iodine therapy (RAI), keloid and hypertrophic scar, recurrence and re-intervention.

All patients underwent total thyroidectomy. In one case, a video-assisted central lymphoadenectomy was performed. A 2.8% conversion rate was found, and these four patients were excluded from the analysis. Postoperative adverse events reported were hemorrhage (1.23%), transient hypocalcemia (7.4%), permanent hypocalcemia (1.23%), permanent recurrent laryngeal nerve (RLN) palsy (1.23%), keloid scar (2.46%). Postoperative RAI was executed in 48 cases (59.2%). With a median follow-up of 14.86 years, only one patient presented a lateral cervical lymph node recurrence and required a lateral cervical lymphadenectomy. No cases of local relapses were reported and no patient died for causes correlated with thyroid carcinoma.

Monitoring the results of our MIVAT procedures series with at least 10-year follow-up, we have found it safe concerning both postoperative complications and oncological outcomes, comparably with other minimally invasive thyroidectomies series and with conventional thyroidectomy. Particularly, among minimally invasive endoscopic techniques, MIVAT offers the best compromise between postoperative complications, costs, execution time and cosmetic results.