Minimally Invasive Video-Assisted Thyroidectomy: Analysis of Complications From a Systematic Review

Surg Innov. 2019 Jun;26(3):381-387. doi: 10.1177/1553350618823425. Epub 2019 Jan 11.

Abstract

Background: Nowadays, minimally invasive video-assisted thyroidectomy (MIVAT) is considered a safe and effective option. However, its complication rate has not been specifically discussed yet. The aim of this systematic review was enrolling a large number of studies to estimate early and late complications (transient and definitive, uni- and bilateral laryngeal nerve palsy; transient and definitive hypocalcemia; cervical hematoma; hypertrophic or keloid scar) of MIVAT compared with conventional technique.

Methods: The review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria in PubMed and Embase. Search terms were "minimally invasive," "video-assisted," and "thyroidectomy." We enrolled randomized clinical trials, nonrandomized trials, and noncontrolled trials.

Results: Thirty-two articles were considered suitable. Complication rate of MIVAT was quite similar to conventional technique: only one randomized trial found a significant difference concerning overall skin complication, and a single trial highlighted hypocalcemia significantly increased in MIVAT, concerning serologic value only. No difference concerning symptomatic nor definitive hypocalcemia was found.

Conclusions: We can confirm that MIVAT is a safe technique. It should be adopted in mean-high-volume surgery centers for thyroidectomy, if a strict compliance with indication was applied.

Keywords: MIVAT; conventional thyroidectomy; definitive complications; minimally invasive video-assisted thyroidectomy; review; transient complications.

Publication types

  • Systematic Review

MeSH terms

  • Humans
  • Minimally Invasive Surgical Procedures / methods*
  • Postoperative Complications*
  • Thyroidectomy / methods*
  • Video-Assisted Surgery / methods*