Frank Ethan, Park Joshua, Simental Alfred, Vuong Christopher, Liu Yuan, Kwon Daniel, Lin Yi, Filho Pedro Andrade
Loma Linda University School of Medicine, Loma Linda, California, USA.
Am Surg. 2016 Oct;82(10):949-952.
Minimally invasive video-assisted thyroidectomy (MIVAT) has gained acceptance as an alternative to conventional thyroidectomy. This technique results in less bleeding, postoperative pain, shorter recovery time, and better cosmetic results without increasing morbidity. We retrospectively assessed outcomes in 583 patients having MIVAT from May 2005 to September 2014. The study population was divided into groups according to periods: 2005 to 2009 and 2010 to 2014. Operative data, complications, and length of stay were collected and compared. Total thyroidectomy was undertaken in 185, completion thyroidectomy in 49, and hemithyroidectomy in 349. Malignancy was present in 127 (21.8%). Mean incision was 3.4 ± 0.7 cm and estimated blood loss was 23.7 ± 21.7 mL. Mean operative time was 86.5 ± 39.3 minutes for all operations, 78.5 ± 37.0 minutes for hemithyroidectomy, 70.9 ± 30.1 minutes for completion thyroidectomy, and 106.8 ± 41.3 minutes for total thyroidectomy. Postoperatively, 56 (9.6%) had unilateral vocal cord dysfunction, which resolved except for one case (0.17%). Fifty-nine patients (10.1%) developed hypocalcemia, but only three cases (0.51%) became permanent. Only one patient required readmission. In conclusion, MIVAT results in short operative times, minimal blood loss, and few complications and is safely performed in an academic institution.
微创视频辅助甲状腺切除术（MIVAT）已被认可为传统甲状腺切除术的替代方法。该技术出血少、术后疼痛轻、恢复时间短且美容效果更好，同时不增加发病率。我们回顾性评估了2005年5月至2014年9月期间接受MIVAT的583例患者的手术结果。研究人群按时间段分为两组：2005年至2009年组和2010年至2014年组。收集并比较了手术数据、并发症及住院时间。行全甲状腺切除术185例，甲状腺次全切除术49例，半甲状腺切除术349例。127例（21.8%）存在恶性病变。平均切口为3.4±0.7 cm，估计失血量为23.7±21.7 mL。所有手术的平均手术时间为86.5±39.3分钟，半甲状腺切除术为78.5±37.0分钟，甲状腺次全切除术为70.9±30.1分钟，全甲状腺切除术为106.8±41.3分钟。术后，56例（9.6%）出现单侧声带功能障碍，除1例（0.17%）外均已恢复。59例（10.1%）发生低钙血症，但仅3例（0.51%）为永久性。仅1例患者需要再次入院。总之，MIVAT手术时间短、失血少、并发症少，在学术机构中可安全进行。
