Our Summary

This research paper is a review of multiple studies comparing the safety and effectiveness of a type of thyroid surgery called minimally invasive video-assisted thyroidectomy (MIVAT) to the traditional surgical method. The study looked at complications such as nerve damage, low calcium levels, bleeding, and scarring. The results showed that the rate of complications with MIVAT was quite similar to the traditional surgery. Only one study found a significant difference in skin complications, and another found a slight increase in low calcium levels with MIVAT, but only when measuring through blood tests and not when looking at symptoms. The researchers concluded that MIVAT is a safe technique and recommended its use in high-volume surgical centers for thyroidectomy, as long as the procedure is used appropriately.

FAQs

  1. What is minimally invasive video-assisted thyroidectomy (MIVAT)?
  2. How does the safety and effectiveness of MIVAT compare to traditional thyroidectomy methods?
  3. What complications were observed in the studies comparing MIVAT to traditional thyroid surgery methods?

Doctor’s Tip

One helpful tip a doctor might tell a patient about thyroidectomy is to follow post-operative care instructions carefully, including taking prescribed medications, attending follow-up appointments, and monitoring for any signs of complications such as difficulty swallowing, voice changes, or excessive bleeding. It is also important to maintain a healthy diet and lifestyle to support overall healing and thyroid function.

Suitable For

Patients who are typically recommended for thyroidectomy include those with:

  1. Thyroid cancer: Patients with thyroid cancer may need to undergo thyroidectomy to remove the cancerous tissue.

  2. Benign thyroid nodules: Patients with large or symptomatic benign thyroid nodules may be recommended for thyroidectomy to alleviate symptoms or for diagnostic purposes.

  3. Hyperthyroidism: Patients with hyperthyroidism that is not controlled with medication or other treatments may be recommended for thyroidectomy to remove the thyroid gland.

  4. Graves’ disease: Patients with Graves’ disease, an autoimmune disorder that causes hyperthyroidism, may be recommended for thyroidectomy if other treatments are not effective.

  5. Recurrent thyroid nodules: Patients with recurrent thyroid nodules may be recommended for thyroidectomy to prevent further growth or complications.

  6. Thyroid goiter: Patients with a large thyroid goiter that causes difficulty swallowing, breathing, or speaking may be recommended for thyroidectomy to alleviate symptoms.

  7. Family history of thyroid cancer: Patients with a family history of thyroid cancer may be recommended for thyroidectomy as a preventive measure.

Overall, the decision to recommend thyroidectomy depends on the specific condition and symptoms of the patient, as well as the risks and benefits of the procedure. It is important for patients to discuss their options with their healthcare provider to determine the best course of treatment for their individual situation.

Timeline

Before thyroidectomy:

  • Patient undergoes physical examination, blood tests, imaging studies, and possibly a biopsy to diagnose thyroid condition
  • Patient may be prescribed medication to manage symptoms and prepare for surgery
  • Patient may need to adjust diet and medications leading up to surgery
  • Patient meets with surgeon to discuss procedure, risks, and benefits
  • Patient may undergo pre-operative testing and clearance from other medical specialists

After thyroidectomy:

  • Patient is monitored closely for complications such as bleeding, infection, and damage to surrounding structures
  • Patient may experience temporary hoarseness, difficulty swallowing, and numbness in the neck and throat
  • Patient may need to take thyroid hormone replacement medication for the rest of their life
  • Patient may need regular follow-up appointments and blood tests to monitor thyroid hormone levels
  • Patient may experience changes in voice, weight, energy levels, and mood post-surgery
  • Patient may undergo physical therapy or speech therapy to address any issues with voice or swallowing
  • Patient may need to make lifestyle changes such as diet modifications and stress management to support thyroid health

What to Ask Your Doctor

  1. What are the potential risks and complications associated with thyroidectomy, both in general and specifically with the minimally invasive video-assisted thyroidectomy (MIVAT) technique?
  2. How experienced are you in performing MIVAT surgeries, and what is your success rate with this technique?
  3. Will I need to take any medications or undergo any additional treatments after the surgery, such as thyroid hormone replacement therapy?
  4. How long is the recovery period after a thyroidectomy, and what can I expect in terms of pain, scarring, and return to normal activities?
  5. Are there any specific lifestyle changes or dietary restrictions I should follow after the surgery?
  6. How often will I need to follow up with you after the surgery for monitoring and evaluation?
  7. Are there any long-term effects or implications of having a thyroidectomy, such as changes in metabolism or hormone levels?
  8. Will I need to undergo any additional testing or imaging studies before or after the surgery to evaluate the thyroid gland and surrounding structures?
  9. What are the chances of the thyroid condition returning after surgery, and are there any preventive measures I can take to reduce this risk?
  10. Are there any alternatives to thyroidectomy that I should consider, and what are the potential benefits and drawbacks of each option?

Reference

Authors: Scerrino G, Melfa G, Raspanti C, Rotolo G, Salamone G, Licari L, Fontana T, Tutino R, Porrello C, Gulotta G, Cocorullo G. Journal: Surg Innov. 2019 Jun;26(3):381-387. doi: 10.1177/1553350618823425. Epub 2019 Jan 11. PMID: 30632464