Report on 8 years of experience with video-assisted thyroidectomy for papillary thyroid carcinoma

BackgroundThe results of video-assisted thyroidectomy in a large series of patients with papillary thyroid carcinoma were evaluated, especially in terms of the completeness of the operative resection.MethodsThe medical records of all patients who underwent video-assisted total thyroid resection (single procedure total thyroidectomy or lobectomy followed by completion thyroidectomy) for papillary thyroid cancer between June 1998 and December 2006 were reviewed.ResultsWe included 271 patients. One hundred two patients underwent central neck node removal by the same approach. Postoperative complications included 5 patients with transient recurrent nerve palsies, 59 with transient hypocalcemia, 3 with permanent hypoparathyroidism, and 1 with postoperative hematoma. Final histology showed the neoplasms to be 215 pT1, 23 pT2, and 33 pT3. Lymph node metastases were found in 19 patients. Follow-up evaluations were completed for 231 patients. Mean postoperative serum thyroglobulin level after levothyroxine withdrawal was 5.5 ng/mL. Postoperative ultrasonography showed no residual thyroid tissue in all patients. Mean postoperative 131I uptake was 2.1%. One patient developed a lateral neck recurrence.ConclusionsThe completeness of the operative resection achieved with video-assisted thyroidectomy seems comparable with that reported for conventional surgery. A longer follow-up is necessary to draw definitive conclusions in terms of recurrence and survival rate.