Minimally invasive thyroidectomy in the treatment of well differentiated thyroid cancers: indications and limits

作者：Miccoli Paolo; Materazzi Gabriele^*; Berti Piero

来源：Current Opinion in Otolaryngology & Head and Neck Surgery, 2010, 18(2): 114-118.

DOI：10.1097/MOO.0b013e3283378239

• endoscopic
• minimally invasive
• papillary carcinoma
• thyroidectomy
• video assisted

Purpose of review
To summarize recent papers in the literature with respect to minimally invasive thyroidectomy and discuss indications and limits of the endoscopic/video-assisted treatment of differentiated thyroid carcinoma.
Recent findings
During the 1990s, with the general tendency to develop minimally invasive operations, an endoscopic approach was applied to neck surgery for both parathyroidectomy and thyroidectomy. The most wide spread minimally invasive technique for thyroidectomy is minimally invasive video-assisted thyroidectomy (MIVAT).
Summary
Papillary carcinoma is the main indication for MIVAT, this cancer usually being found in normal glands of young women. In contrast, for locally invasive carcinomas, lymph node metastasis or both, the procedure must be immediately converted to the conventional technique. MIVAT also is not indicated for the treatment of medullary and anaplastic carcinomas. Recent prospective randomized studies clearly demonstrate that MIVAT allows the same clearance to be achieved at the thyroid bed level and the same outcome as with the conventional technique, when dealing with 'low-risk' papillary carcinoma. At the same time, patients can benefit from the main advantages of this minimally invasive technique: less postoperative pain, faster postoperative recovery and excellent cosmetic outcome.

• 出版日期2010-4