Nenkov R, Radev R, Madjov R
Clinic of Thoracic Surgery, UMHAT "St. Marina", Medical University, Varna, Bulgaria.
Khirurgiia (Sofiia). 2013(2):15-9.
One of the challenges of the minimally invasive video-assisted thyroid resections is their application for the surgical treatment of papillary thyroid carcinoma.
To present our experience with the use of video-assisted thyroid resections with harmonic scalpel in the surgical treatment of patients with papillary thyroid carcinoma.
259 patients with thyroid nodules were operated in our Clinic for a five-year period--from 2008 to 2013--via a video-assisted technique. Thyroid carcinoma was found in 53 patients (46 female patients and seven male patients, aged 18 to 52 years). The patients were selected according to the established criteria, developed and adopted in our Clinic. The resection was performed using endoscopic harmonic scalpel (Ultracision CS-14C; produced by Ethicon Endo-Surgery Care). The surgical incision length, extent of surgery, duration of operative time, type and incidence of complications (intraoperative and postoperative), period of hospital stay, and safety and radicality of the surgical procedure were examined.
The length of the surgical incision was from 1.5 to 2.5 cm in all operated patients. The tumor size varied from 0.5 to 2.0 cm. Papillary carcinoma was found in 42 patients and follicular variant of papillary thyroid carcinoma--in eleven patients. Minimally invasive video-assisted thyroidectomy (MIVAT), using harmonic scalpel and 5 mm optics, was performed in 42 patients and video-assisted lobectomy with near-total resection of the contralateral lobe was performed in the remaining eleven patients. Lymph node micrometastases in the central cervical compartment were found in four patients. Draining of thyroid gland bed was performed in three patients. Transient hypocalcemia was found in one patient. All patients were discharged within the first 24 postoperative hours.
Our results confirm that, if the criteria for selection of patients are followed, the video-assisted thyroid resections with harmonic scalpel have a place in the surgical treatment of selected patients with papillary thyroid carcinoma.
