Miccoli Paolo, Matteucci Valeria
Department of Surgery, University of Pisa, Pisa, Italy.
Gland Surg. 2015 Oct;4(5):365-7. doi: 10.3978/j.issn.2227-684X.2015.04.17.
Today is well known that endoscopic thyroidectomy could reach the same level of completeness as a conventional operation. We have been using minimally invasive video assisted thyroidectomy (MIVAT) as our favorite minimally invasive access to thyroid diseases from the late nineties.
Our experience with MIVAT is represented by 2,413 cases between 1998 and 2014: in particular 821 patients were operated with a total thyroidectomy for a papillary carcinoma (34.0%). Furthermore 967 patients underwent a MVAT for the presence of an undetermined lesion (40.0%).
The conversion rate was very low: 24 patients (1.0%), mainly due to: unexpected posterior tracheal invasions (nine patients), involvement of lymph nodes not evident at echography (four patients), esophageal infiltration (three patients), strap muscles infiltration (three patients) and finally in five cases the presence of serious thyroiditis that had escaped to ultrasonographic evaluation.
The minimally MIVAT to treat malignant thyroid tumors has today a very clear indication for malignancies.
如今众所周知，内镜甲状腺切除术可达到与传统手术相同的完整程度。自九十年代后期以来，我们一直将微创视频辅助甲状腺切除术（MIVAT）作为治疗甲状腺疾病最常用的微创方法。
我们在1998年至2014年间对2413例患者进行了MIVAT手术：其中821例患者因乳头状癌接受了全甲状腺切除术（34.0%）。此外，967例患者因存在未明确的病变接受了MIVAT手术（40.0%）。
中转率非常低：24例患者（1.0%），主要原因包括：意外的气管后侵犯（9例患者）、超声检查未发现的淋巴结受累（4例患者）、食管浸润（3例患者）、带状肌浸润（3例患者），最后5例患者存在超声检查漏诊的严重甲状腺炎。
如今，MIVAT微创治疗甲状腺恶性肿瘤对恶性肿瘤具有非常明确的适应证。
