Scerrino Gregorio, Melfa Giuseppina, Raspanti Cristina, Rotolo Giulia, Salamone Giuseppe, Licari Leo, Fontana Tommaso, Tutino Roberta, Porrello Calogero, Gulotta Gaspare, Cocorullo Gianfranco
1 University of Palermo, Palermo, Italy.
Surg Innov. 2019 Jun;26(3):381-387. doi: 10.1177/1553350618823425. Epub 2019 Jan 11.
Nowadays, minimally invasive video-assisted thyroidectomy (MIVAT) is considered a safe and effective option. However, its complication rate has not been specifically discussed yet. The aim of this systematic review was enrolling a large number of studies to estimate early and late complications (transient and definitive, uni- and bilateral laryngeal nerve palsy; transient and definitive hypocalcemia; cervical hematoma; hypertrophic or keloid scar) of MIVAT compared with conventional technique.
The review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria in PubMed and Embase. Search terms were "minimally invasive," "video-assisted," and "thyroidectomy." We enrolled randomized clinical trials, nonrandomized trials, and noncontrolled trials.
Thirty-two articles were considered suitable. Complication rate of MIVAT was quite similar to conventional technique: only one randomized trial found a significant difference concerning overall skin complication, and a single trial highlighted hypocalcemia significantly increased in MIVAT, concerning serologic value only. No difference concerning symptomatic nor definitive hypocalcemia was found.
We can confirm that MIVAT is a safe technique. It should be adopted in mean-high-volume surgery centers for thyroidectomy, if a strict compliance with indication was applied.
如今，微创视频辅助甲状腺切除术（MIVAT）被认为是一种安全有效的选择。然而，其并发症发生率尚未得到具体讨论。本系统评价的目的是纳入大量研究，以评估与传统技术相比，MIVAT的早期和晚期并发症（短暂性和永久性、单侧和双侧喉返神经麻痹；短暂性和永久性低钙血症；颈部血肿；肥厚性或瘢痕疙瘩样瘢痕）。
根据PRISMA（系统评价和Meta分析的首选报告项目）标准在PubMed和Embase中进行评价。检索词为“微创”、“视频辅助”和“甲状腺切除术”。我们纳入了随机临床试验、非随机试验和非对照试验。
32篇文章被认为合适。MIVAT的并发症发生率与传统技术相当：只有一项随机试验发现总体皮肤并发症存在显著差异，一项试验仅在血清学值方面突出显示MIVAT中低钙血症显著增加。在有症状的或永久性低钙血症方面未发现差异。
我们可以确认MIVAT是一种安全的技术。如果严格遵守适应症，应在中高手术量的甲状腺手术中心采用。
