Abstract:
Objective To compare the effectiveness and safety of and the presence of postoperative scars in minimally invasive videoassisted thyroidectomy (MIVAT) through the suprasternal notch approach and conventional open thyroid surgery (OTS) in patients with clinically node-negative (cN0) papillary thyroid carcinoma (PTC).
Methods We enrolled 80 patients with cN0 PTC who underwent MIVAT through the suprasternal notch approach at Fudan University Shanghai Cancer Center between January 2012 and December 2017. A total of 160 patients with cN0 PTC who underwent OTS at our hospital were selected using the random number table method in a 1 : 2 ratio. The patients underwent lobectomy or total thyroidectomy and prophylactic central neck dissection. The Chi-square test, Kaplan-Meier survival analysis, and Log-rank test were used to determine the differences between the two surgical procedures.
Results The mean operative time in the MIVAT group was longer than that in the OTS group (P=0.003). The length of hospital stay in the MIVAT group was significantly shorter than that in the OTS group (P < 0.001). There was no significant difference in the postoperative recurrence rate, the number of dissected lymph nodes and positive lymph nodes between the two groups (P>0.05). The incidence of complications such as recurrent laryngeal nerve injury, postoperative hematoma, and infection was comparable between the two groups (P> 0.05). Furthermore, there was no significant difference in the modified Vancouver scar scale (VSS) score between the two groups; however, the length of the cervical scar in the MIVAT group was significantly reduced compared to that in the OTS group (P < 0.001).
Conclusions There is no significant difference in the effectiveness and safety of MIVAT and OTS in patients with cN0 PTC. Although the modified VSS scores of the two procedures are comparable, the use of MIVAT significantly reduces the length of the neck incision. Therefore, MIVAT can provide a better cosmetic effect and consequently be widely used in clinical practice.