Safety and feasibility of thyroid lobectomy via a lateral 2.5-cm incision with a cohort comparison of the first 50 cases: evolution of a surgical approach

Abstract

Background and aims: Over 500 minimal-access parathyroidectomies (MIPs) have been performed in our unit, and, from these, a technique for thyroid resection has evolved. We present a report on the evolution of minimal-access thyroid surgery (MATS) and compare the results with those from a cohort of patients operated on prior to the use of MATS.

Methods: We reviewed the evolution towards the MATS technique. The results of the MATS procedures were compared with those from an equal number of consecutive patients undergoing conventional lobectomy prior to the use of MATS.

Results: Fifty patients (mean age 45.6 years) underwent MATS between March 2002 and May 2004. The mean nodule diameter was 18.5 mm. In the MATS group there was one recurrent laryngeal nerve (RLN) injury, two temporary RLN neuropraxias, which recovered, and one haematoma. The control group (mean age 47.9 years) had a mean nodule size of 22 mm. In the controls there was one temporary RLN neuropraxia, which recovered, and two haematomas-P>0.05 (Fisher's exact test) for all the complications.

Conclusions: MATS has evolved from an experimental approach into a safe and feasible surgical procedure based on the same operative approach as used for MIP. It provides an alternative to open thyroid surgery in appropriately selected cases.