Efficacy of minimally invasive video-assisted thyroidectomy for completion thyroidectomy

Objective: Minimally invasive video-assisted thyroidectomy (MIVAT) is among the most common alternatives to conventional open thyroidectomy. Previous reports have shown it to be safe and effective in patients without neck surgery history. However, this contraindication has been called into question...

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Main Authors: Ethan Frank, Joshua Park, Christopher Vuong, Lydia Kore, Alfred Simental
Format: Article
Language:English
Published: KeAi Communications Co., Ltd. 2021-03-01
Series:Laparoscopic, Endoscopic and Robotic Surgery
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2468900920300736
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author Ethan Frank
Joshua Park
Christopher Vuong
Lydia Kore
Alfred Simental
author_facet Ethan Frank
Joshua Park
Christopher Vuong
Lydia Kore
Alfred Simental
author_sort Ethan Frank
collection DOAJ
description Objective: Minimally invasive video-assisted thyroidectomy (MIVAT) is among the most common alternatives to conventional open thyroidectomy. Previous reports have shown it to be safe and effective in patients without neck surgery history. However, this contraindication has been called into question in more recent small series. This study aims to evaluate the efficacy and safety of MIVAT in patients with prior neck surgery. Methods: We retrospectively reviewed the data of 178 patients who underwent completion thyroidectomy in the Department of Otolaryngology-Head and Neck Surgery at Loma Linda University Medical Center between July 2004 and July 2017. Patients were divided into MIVAT group and Conventional group based on method of surgery, and analysis with two sample tests of proportions was carried out as appropriate. Results: Patients in MIVAT group had significantly shorter operative time (74.1 ± 26.4 min vs. 99.0 ± 49.3 min, p < 0.001), less estimated blood loss (19.5 ± 15.0 mL vs. 39.0 ± 65.9 mL, p = 0.002), smaller incision size (3.5 ± 1.1 cm vs. 6.2 ± 2.2 cm, p < 0.001), and a lighter thyroid weight (7.5 ± 5.2 g vs. 20.5 ± 31.1 g, p < 0.001). The average length of stay was a half day longer, and post-operative admission was higher (78.8% vs. 51.7%, p = 0.005) in MIVAT group, while most was for routine 23-hour observation (63.6% vs. 35.9%, p = 0.009). There were no differences in complications. Conclusion: MIVAT is feasible for re-operative patients with equivalent or superior outcomes to those of conventional thyroidectomy, and no significant difference in the incidences of common postoperative complications.
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spelling doaj.art-717357e0f55d46709cb443fb03029db72022-12-21T22:23:36ZengKeAi Communications Co., Ltd.Laparoscopic, Endoscopic and Robotic Surgery2468-90092021-03-01411418Efficacy of minimally invasive video-assisted thyroidectomy for completion thyroidectomyEthan Frank0Joshua Park1Christopher Vuong2Lydia Kore3Alfred Simental4Department of Otolaryngology-Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, 92354, USA; Corresponding author: Department of Otolaryngology-Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, 92354, USA.Department of Otolaryngology-Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, 92354, USADepartment of Otolaryngology-Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, 92354, USALoma Linda University School of Medicine, Loma Linda, CA, 92350, USADepartment of Otolaryngology-Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, 92354, USAObjective: Minimally invasive video-assisted thyroidectomy (MIVAT) is among the most common alternatives to conventional open thyroidectomy. Previous reports have shown it to be safe and effective in patients without neck surgery history. However, this contraindication has been called into question in more recent small series. This study aims to evaluate the efficacy and safety of MIVAT in patients with prior neck surgery. Methods: We retrospectively reviewed the data of 178 patients who underwent completion thyroidectomy in the Department of Otolaryngology-Head and Neck Surgery at Loma Linda University Medical Center between July 2004 and July 2017. Patients were divided into MIVAT group and Conventional group based on method of surgery, and analysis with two sample tests of proportions was carried out as appropriate. Results: Patients in MIVAT group had significantly shorter operative time (74.1 ± 26.4 min vs. 99.0 ± 49.3 min, p < 0.001), less estimated blood loss (19.5 ± 15.0 mL vs. 39.0 ± 65.9 mL, p = 0.002), smaller incision size (3.5 ± 1.1 cm vs. 6.2 ± 2.2 cm, p < 0.001), and a lighter thyroid weight (7.5 ± 5.2 g vs. 20.5 ± 31.1 g, p < 0.001). The average length of stay was a half day longer, and post-operative admission was higher (78.8% vs. 51.7%, p = 0.005) in MIVAT group, while most was for routine 23-hour observation (63.6% vs. 35.9%, p = 0.009). There were no differences in complications. Conclusion: MIVAT is feasible for re-operative patients with equivalent or superior outcomes to those of conventional thyroidectomy, and no significant difference in the incidences of common postoperative complications.http://www.sciencedirect.com/science/article/pii/S2468900920300736ThyroidectomyMinimally invasive surgeryReoperation
spellingShingle Ethan Frank
Joshua Park
Christopher Vuong
Lydia Kore
Alfred Simental
Efficacy of minimally invasive video-assisted thyroidectomy for completion thyroidectomy
Laparoscopic, Endoscopic and Robotic Surgery
Thyroidectomy
Minimally invasive surgery
Reoperation
title Efficacy of minimally invasive video-assisted thyroidectomy for completion thyroidectomy
title_full Efficacy of minimally invasive video-assisted thyroidectomy for completion thyroidectomy
title_fullStr Efficacy of minimally invasive video-assisted thyroidectomy for completion thyroidectomy
title_full_unstemmed Efficacy of minimally invasive video-assisted thyroidectomy for completion thyroidectomy
title_short Efficacy of minimally invasive video-assisted thyroidectomy for completion thyroidectomy
title_sort efficacy of minimally invasive video assisted thyroidectomy for completion thyroidectomy
topic Thyroidectomy
Minimally invasive surgery
Reoperation
url http://www.sciencedirect.com/science/article/pii/S2468900920300736
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