Klinik für Chirurgie und Zentrum für Minimal Invasive Chirurgie, Evang. Kliniken Essen-Mitte, Henricistrasse 92, 45136, Essen, Germany.
Evangelisches Krankenhaus Oldenburg, Steinweg 13-17, 26122, Oldenburg, Germany.
Langenbecks Arch Surg. 2021 Aug;406(5):1625-1633. doi: 10.1007/s00423-021-02196-8. Epub 2021 May 13.
We present the long-term cosmetic results of the video-assisted thyroidectomy (MIVAT) in comparison to the conventional operation.
Forty-eight patients (four males, 44 females; mean age 47.4 ± 12.5 years) constituted the video-assisted group (VA-Group). These were compared with 48 patients (10 males, 38 females; mean age 47.4 ± 12.5 years) operated by conventional surgery (C-Group). The patients were selected from all thyroid operations performed between January 2016 and June 2017. Patient Scar Assessment Scale (PSAS) and Observer Scar Assessment Scale (OSAS) were used for the evaluation performed by an independent surgeon. Both scales contained six items scored numerically on a ten-step scale ranging from 1 (normal skin) to 10 (worst result). Moreover, photos of all scars were taken and analyzed by six team surgeons using modified OSAS.
The mean follow-up time was 31.7 ± 6.4 months for the MIVAT group and 32.9 ± 4.6 months for the conventional group (p = 0.39). The mean scar length in the VA-Group was 2.6 cm vs. 3.8 cm in the C-Group (p < 0.0001). The total score of PSAS was 9.93 (6-35) for MIVAT and 9.72 (6-29) for conventional thyroidectomy (p = 0.22). The total OSAS score by the independent surgeon showed a better cosmetic outcome for conventional surgery (13.19 vs. 12.33; p = 0.01). The total OSAS score by the six team surgeons did not differ between both groups in five of six ratings; one surgeon favored MIVAT (12.2 vs. 13.6; p = 0.04).
This study does not find cosmetic advantages of minimally invasive video-assisted thyroidectomy compared to conventional thyroidectomy.
本研究旨在比较视频辅助甲状腺切除术（MIVAT）与传统手术的长期美容效果。
48 例患者（男 4 例，女 44 例；平均年龄 47.4±12.5 岁）纳入视频辅助组（VA 组）。将其与同期 48 例患者（男 10 例，女 38 例；平均年龄 47.4±12.5 岁）行传统手术（C 组）进行比较。所有患者均选自 2016 年 1 月至 2017 年 6 月期间进行的所有甲状腺手术。采用独立外科医生进行的患者瘢痕评估量表（PSAS）和观察者瘢痕评估量表（OSAS）进行评估。这两个量表都包含 6 个项目，每个项目在 10 分制范围内评分，从 1（正常皮肤）到 10（最差结果）。此外，所有瘢痕的照片均由 6 位团队外科医生使用改良的 OSAS 进行拍摄和分析。
MIVAT 组的平均随访时间为 31.7±6.4 个月，传统组为 32.9±4.6 个月（p=0.39）。VA 组的平均瘢痕长度为 2.6cm，C 组为 3.8cm（p＜0.0001）。MIVAT 的 PSAS 总分为 9.93（6-35），传统甲状腺切除术为 9.72（6-29）（p=0.22）。独立外科医生的 OSAS 总评分显示传统手术的美容效果更好（13.19 比 12.33；p=0.01）。六位团队外科医生的 OSAS 总评分在六个评分中的五个评分中，两组之间没有差异；一位外科医生更喜欢 MIVAT（12.2 比 13.6；p=0.04）。
与传统甲状腺切除术相比，微创视频辅助甲状腺切除术在美容方面并无优势。
