Endocrine Abstracts

Introduction: Minimally invasive video-assisted thyroidectomy (MIVAT) was introduced for the treatment of selected patients. Our experience from 2005 indicates that outcome of surgery in differentiated thyroid cancer (DTC) is comparable in patients treated with MIVAT vs conventional thyroidectomy; minimally invasive technique is characterized by a better postoperative discomfort.

Material and methods: In this prospective study from July 2005 to December 2009, 284 patients with cytological negative node underwent either MIVAT (n=102) or conventional thyroidectomy (n=182). The following criteria for MIVAT were applied: thyroid volume, nodule size, and pathological criteria. We have collected age, nodule mean size, operative time, serum calcium level pre and post surgery. In follow-up these data were recorded: cumulative dose of radio-active iodine (RAI) and serum thyroglobulin (Tg) at 5 years.

Results: The clinical parameters of the MIVAT and conventional thyroidectomy groups were comparable except for age (mean 44.8±9.9 years vs 52.3±14.1 years, P=0.03) and operative time (mean 63±23.5 min vs 54±15.4 min, P=0.02); the mean tumour size was similar between groups (1.3±0.6 cm vs 1.6±0.8 cm, P=0.15). Surgical morbidity was similar in both groups. Median follow-up was 5 years. RAI dose (mean 73±36 mCu vs 97±45 mCu, P=0.33) and serum Tg at 5 years (mean 0.4±0.1 years vs 0.4±0.2 years, P=0.3) were not significantly different between the minimally invasive and the conventional thyroidectomy groups.

Conclusion: MIVAT can be safely utilised in patients with DTC providing early oncological outcome comparable to conventional thyroidectomy. Patients treated with minimally invasive surgery showed an improvement of postoperative pain and cosmetic result.