Minimally invasive video-assisted thyroidectomy versus conventional thyroidectomy for benign thyroid disease

Minimally invasive video-assisted thyroidectomy [MIVAT] has been demonstrated to be a safe procedure with additional advantages regarding cosmetic results and postoperative outcome. The present study was conducted to define the advantages and disadvantages of MIVAT as compared to conventional thyroidectomy [CT]. Between January 2008 and January 2010, 28 patients underwent MIVAT. A similar number of patients who underwent conventional thyroidectomy [CT] before the introduction of the MIVAT technique at our department were chosen with the same inclusion criteria used for MIVAT and served as matched controls. The eligibility criteria for both groups was thyroid nodules<35 mm, thyroid volume<25 ml, no thyroiditis, no malignancy, and no previous cervical conventional surgery or irradiation. No differences were found between both groups in terms of age, gender, thyroid volume, maximum nodule diameter, indication for surgery and postoperative complications MIVAT provided a significantly smaller cervical incision, less postoperative pain and parenteral analgesics during the first postoperative day, better cosmetic results, and shorter hospital stay than patients who underwent CT. Operative time was, however, significantly [P=0.001] longer with MIVAT than with CT [75 +/- 18 min versus 55 +/- 12 min, respectively]. The MIVAT technique, in selected patients, seems to be a valid option for thyroidectomy with postoperative complications similar to CT. Though with a longer operative time, MIVAT may even be preferable to CT, because of its significant advantages, in terms of better cosmetic result, less postoperative pain, and shorter hospital stay