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A Multi-institutional North American Experience

David J. Terris, MD; Peter Angelos, MD, PhD; David L. Steward, MD; Alfred A. Simental, MD

Arch Otolaryngol Head Neck Surg. 2008;134(1):81-84.

Objective  To report the results of a multi-institutional experience with the minimally invasive video-assisted thyroidectomy, which was conceived in Europe and Asia and has only recently been embraced in the United States.

Design  Prospective, nonrandomized analysis.

Setting  Four academic thyroid surgical practices.

Patients  Consecutive series of 228 patients who required thyroid surgery and were deemed at surgeon discretion to be eligible for a minimal access surgery.

Interventions  Minimally invasive video-assisted thyroidectomy was performed in 216 patients.

Main Outcome Measures  The data, which were recorded prospectively, included age, sex, indication for surgery, incision length, and complications of surgery.

Results  Because conversion to an open approach was required in 12 of the 228 patients, the study group comprised 216 patients (25 men and 191 women; mean [SD] age, 44.5 [14.1] years). There were no hematomas and no cases of permanent hypoparathyroidism or permanent vocal cord paralysis. Nine patients had a transient vocal cord paresis (3.2% of nerves at risk); 5 patients experienced temporary hypocalcemia (8.1% of total thyroidectomies); 1 patient reported a change in voice pitch; and 1 patient required a scar revision.

Conclusions  Use of the minimally invasive video-assisted thyroidectomy technique has been adopted cautiously in the United States. The safety of the procedure represented by the data from this multi-institutional experience would support its expanded adoption by high-volume thyroid surgeons.

Author Affiliations: Department of Otolaryngology–Head and Neck Surgery, Medical College of Georgia, Augusta (Dr Terris); Department of Surgery (Division of Endocrine Surgery), Northwestern University, Chicago, Illinois (Dr Angelos); Department of Otolaryngology–Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio (Dr Steward); and Department of Surgery, Division of Otolaryngology–Head and Neck Surgery, Loma Linda University, Loma Linda, California (Dr Simental). Dr Angelos is now with the Department of Surgery (Division of Endocrine Surgery), University of Chicago.