Tiroidectomia video-assistita per carcinoma papillifero della tiroide

AIM. The results of video-assisted thyroidectomy (VAT) in a large series of patients with papillary thyroid carcinoma (PTC) were evaluated, especially in terms of the completeness of the surgical 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 PTC between June 1998 and December 2006 were reviewed. RESULTS. Two hundred and seventy-one patients were included. One hundred and two patients underwent central neck node removal by the same approach. Post-operative complications included 5 transient recurrent nerve palsies, 59 transient hypocalcemia cases, 3 permanent hypoparathyroidism cases and 1 postoperative haematoma. Final histology showed 215 pT1, 23 pT2, and 33 pT3 PTCs. Lymph node metastases were found in 19 cases. Follow-up evaluations were completed for 231 patients. Mean postoperative serum thyroglobulin (sTg) level after levothyroxine (LT4) withdrawal was 5.5 ng/ml. Post-operative ultrasonography showed no residual thyroid tissue in all patients. Mean post-operative 131I uptake was 2.1%. One patient developed lateral neck recurrence. CONCLUSIONS. The completeness of the surgical resection achieved with VAT seems comparable to that reported for conventional surgery. A longer follow-up is necessary to draw definitive conclusions in terms of recurrence and survival rate.