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

BACKGROUND: The 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. METHODS: The 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. RESULTS: We 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 (131)I uptake was 2.1%. One patient developed a lateral neck recurrence. CONCLUSIONS: The 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.