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Original Article
March 2002

Video-Assisted vs Conventional Thyroid Lobectomy: A Randomized Trial

Author Affiliations

From the Division of Endocrine Surgery, Department of Surgical Science, Universit[[agrave]] Cattolica del Sacro Cuore, Rome, Italy.

Arch Surg. 2002;137(3):301-305. doi:10.1001/archsurg.137.3.301

Hypothesis  Video-assisted thyroid lobectomy improves the cosmetic outcome of the cutaneous scar and reduces postoperative pain.

Participants  Patients admitted to the Division of Endocrine Surgery of the Università Cattolica del Sacro Cuore, Rome, Italy, between March 1999 and December 2000 who were candidates for thyroid lobectomy because of a single, small (≤3 cm) thyroid nodule were considered eligible. Of the 62 patients who were randomized, 31 underwent conventional thyroid lobectomy (COS group), and 31 underwent video-assisted surgery without carbon dioxide neck insufflation (VAS group), a new technique created by the authors.

Results  The cosmetic outcome was evaluated by scoring patients' satisfaction with their scars. Satisfaction was higher in the VAS group (mean ± SD, 9.2 ± 0.5) than the COS group (mean ± SD, 5.8 ± 0.7) (P<.001). Postoperative pain in the first and second days after surgery was lower in the VAS group (mean ± SD, 1.8 ± 0.2 and 1.2 ± 0.1, respectively) than in the COS group (mean ± SD, 6.2 ± 0.2 and 5.8 ± 0.2, respectively) (P<.001). There were no significant differences in complications (eg, bleeding, wound infection, permanent recurrent nerve palsy). Postoperative hospital stay was lower in the VAS group (mean ± SD, 1.1 ± 0.1 days) than in the COS group (mean ± SD, 2.2 ± 0.2 days) (P<.05).

Conclusion  Video-assisted thyroid lobectomy is a valid alternative to conventional surgery in patients with single, small nodular thyroid lesions.