Surgical endoscopy · 2009
Comparison of video-assisted thyroidectomy and traditional thyroidectomy for the treatment of papillary thyroid carcinoma.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Wu Chun-Ting, Yang Li-Heng, Kuo Shou-Jen
Аннотация
BACKGROUND: There is concern regarding the oncological effectiveness of minimally invasive video-assisted thyroidectomy (VAT) for thyroid carcinoma. This study compared the surgical results of VAT and traditional thyroidectomy in patients with small papillary thyroid carcinomas (PTC).
METHODS: Of 44 patients with PTC offered the choice between VAT and traditional thyroidectomy, 21 underwent VAT and 23 underwent traditional thyroidectomy. Residual thyroid tissue and function were assessed postoperatively by measuring thyroid-stimulating hormone (TSH), T4, thyroglobulin, and anti-thyroglobulin antibody levels and with sonographic examination.
RESULTS: Operative time, maximum tumor size, number of positive lymph nodes, and TSH and T4 levels 4 weeks postoperatively were similar in the two groups (all p > 0.05). Patients in the traditional thyroidectomy group had significantly higher postoperative serum thyroglobulin levels 4 weeks after surgery than did patients in the VAT group (5.4 versus 0.5 ng/ml, respectively; p = 0.007). Postoperative ultrasonography showed no residual thyroid tissue or evidence of recurrence in any of the patients. The median follow-up period was 60 months (range 31-77 month) for the VAT group and 53 months (range 31-80 months) for the traditional thyroidectomy group. Thyroglobulin levels of all patients in both groups decreased to <0.2 ng/ml at last follow-up.
CONCLUSIONS: VAT is safe and effective for the treatment of small papillary thyroid carcinomas, and has similar oncological effectiveness to traditional thyroidectomy.
METHODS: Of 44 patients with PTC offered the choice between VAT and traditional thyroidectomy, 21 underwent VAT and 23 underwent traditional thyroidectomy. Residual thyroid tissue and function were assessed postoperatively by measuring thyroid-stimulating hormone (TSH), T4, thyroglobulin, and anti-thyroglobulin antibody levels and with sonographic examination.
RESULTS: Operative time, maximum tumor size, number of positive lymph nodes, and TSH and T4 levels 4 weeks postoperatively were similar in the two groups (all p > 0.05). Patients in the traditional thyroidectomy group had significantly higher postoperative serum thyroglobulin levels 4 weeks after surgery than did patients in the VAT group (5.4 versus 0.5 ng/ml, respectively; p = 0.007). Postoperative ultrasonography showed no residual thyroid tissue or evidence of recurrence in any of the patients. The median follow-up period was 60 months (range 31-77 month) for the VAT group and 53 months (range 31-80 months) for the traditional thyroidectomy group. Thyroglobulin levels of all patients in both groups decreased to <0.2 ng/ml at last follow-up.
CONCLUSIONS: VAT is safe and effective for the treatment of small papillary thyroid carcinomas, and has similar oncological effectiveness to traditional thyroidectomy.