Comparison of minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a single-blinded, randomized controlled clinical trial

Gouda Mohamed El-labban

Department of General Surgery, Faculty of Medicine, Suez Canal University, Ismailia, Egypt

Aim: We aimed to test the hypothesis that minimally invasive video-assisted thyroidectomy (MIVAT) affords comparable safety and efficacy as open conventional surgery in patients with unilateral thyroid nodules or follicular lesions in terms of cosmetic results, intraoperative and postoperative complications, postoperative pain, and hospital stay.

Methods: A single-blinded randomized controlled trial compared MIVAT with conventional thyroidectomy. The primary endpoints of the study were measurement of postoperative pain after 24 and 48 hours and cosmetic outcome 3 months postoperatively. The secondary outcome measures were operative time, incidence of recurrent laryngeal nerve injury, length of incision, and hospital stay.

Results: Operative time was less with open thyroidectomy than with MIVAT, while MIVAT was associated with less pain 24 hours postoperatively. Pain score showed statistically significant differences in favor of MIVAT after 24 hours. MIVAT was associated with less scarring and more satisfaction with cosmetic results. There was no difference between both procedures for presence of transient recurrent laryngeal nerve palsy and hypoparathyroidism.

Conclusion: MIVAT is a safe procedure that produces outcomes similar to those of open thyroidectomy, and is superior in terms of immediate postoperative pain and cosmetic results

Keywords: endoscopic neck surgery, mini-incision