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Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312 773X (Online)
Issue: 2013, vol. 19, book 1;
Subject Collection: Medicine
Page: 416-419
DOI: 10.5272/jimab.2013191.416
Published online: 10 June 2013
J of IMAB. 2013; 19(1):416-419;
MINIMALLY INVASIVE OPEN THYROIDECTOMY IN THYROID CANCER WITH COEXISTENT HASHIMOTO THYROIDITIS
Rumen Nenkov
, Radoslav Radev, Borislav Petrov, Nikolay Cvetkov, Anatoli Semkov, Ekaterina Marinova, Nedyalko Nedyalkov
Department of Thoracic surgery, UMHAT "St. Marina", Clinic of Thoracic surgery, UMHAT "St. Marina",
Medical University of Varna, Bulgaria.
ABSTRACT:
One of the minimally invasive thyroidectomy challenges is the application of this technique in the surgical treatment of thyroid cancer. The use of minimally invasive open approach in co-existence of thyroid cancer with Hashimoto thyroiditis is well known provocation to the skills of the surgeon working in the field of thyroid surgery.
Aim: To report our results and to present the possibilities of minimally invasive open approach in the surgical treatment of thyroid carcinoma and coexistent Hashimoto thyroiditis.
Patients and methods: For the period from 2008 to 2011, 641 patients were operated on in our clinic using minimally invasive open approach. In 32 of these patients presence of Hashimoto thyroiditis was found in combination with thyroid cancer. All patients were females, 26 to 46 years age. Patients were selected according to designed and accepted for our institution criteria. The procedures were performed using ultrasound (harmonic) shears (Harmonic Focus® and Harmonic Ace®, Ethicon Endo-Surgery). The operative time, incidence, type and severity of complications, length of hospital stay, safety and reliability of the surgical procedure were analyzed.
Results: The operative incision length in all cases was between 2.0-2.5 cm. In 27 patients papillary thyroid carcinoma and in 5 patients – follicular variant of the neoplasm were found. The tumor size ranged between 0.5 and 1.5 cm. In all patients total thyroidectomy using harmonic scalpel was performed. Lymph node metastases in the central neck compartment were not found in any of the cases. The rate, type and severity of complications did not exceed those for patients who underwent conventional thyroidectomy. All patients leaved the hospital in the first 24 postoperative hours. The follow-up did not reveal remnant thyroid tissue in thyroid gland bed or recurrence of the disease.
Conclusions: Our results demonstrate the feasibility and reliability of minimally invasive open approach with harmonic scalpel in the surgical treatment of carefully selected patients with non-advanced thyroid cancer and coexistent Hashimoto thyroiditis.
Key words: minimally invasive open thyroidectomy, harmonic scalpel, thyroid cancer, Hashimoto thyroiditis.
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Please cite this article as:
Nenkov R, Radev R, Petrov B, Cvetkov N, Semkov A, Marinova E, Nedyalkov N. MINIMALLY INVASIVE OPEN THYROIDECTOMY IN THYROID CANCER WITH COEXISTENT HASHIMOTO THYROIDITIS . J of IMAB. 2013; 19(1):416-419. DOI: 10.5272/jimab.2013191.416.
Correspondence to: Rumen Nenkov, MD, PhD; Clinic of Thoracic Surgery, UMHAT "St. Marina", Medical University, Varna; 1 “Hristo Smirnenski” Str., Varna, Bulgaria
REFERENCES:
1. Terris DJ. Effect of video-assisted thyroidectomy on the risk of early postthyroidectomy voice and swallowing symptoms. World J Surg. 2008 May;32(5):701. [PubMed] [CrossRef]
2. Miccoli P, Pinchera A, Materazzi G, Biagini A, Berti P, Faviana P, et al. Surgical Treatment of Low- and Intermediate-Risk Papillary Thyroid Cancer with Minimally Invasive Video-Assisted Thyroidectomy. J Clin Endocrinol Metab. 2009 May;94(5):1618–1622. [PubMed] [CrossRef]
3. Del Rio P, Sommaruga L, Pisani P, Palladino S, Arcuri MF, Franceschin M, et al. Minimally invasive video-assisted thyroidectomy in differentiated thyroid cancer: a 1-year follow-up. Surg Laparosc Endosc Percutan Tech. 2009 Aug;19(4):290-2. [PubMed] [CrossRef]
4. Nenkov R, Radev R, Hristozov K. Potentiality of minimally invasive open approach with harmonic scalpel in the surgical treatment of thyroid carcinoma. Endocrine journal. 57: s464-s464 suppl. 2 mar 2010
5. Nenkov r, Radev R, Bulqshky D, Cvetkov N, Semkov A, Marinova K, et al. Videoasisted Thyroidectomy for thyroid cancer. XVІІ National Congress of Surgery - Varna, 11-14 October 2012. Abstract book page. 557 – 564. [in Bulgarian] .
6. Miccoli P, Berti P, Conte M, Bendinelli C, Marcocci C. Minimally invasive surgery for thyroid small nodules: preliminary report. J Endocrinol Invest. 1999 Dec;22(11):849–851. [PubMed]
7. Shimizu K, Akira S, Jasmi AY, Kitamura Y, Kitagawa W, Akasu H, et al. Video-assisted neck surgery: endoscopic resection of thyroid tumors with a very minimal neck wound. J Am Coll Surg. 1999 Jun;188(6):697-703. [PubMed]
8. Bellantone R, Lombardi CP, Raffaelli M, Rubino F, Boscherini M, Perilli W. Minimally invasive, totally gasless video-assisted thyroid lobectomy. Am J Surg. 1999 Apr;177(4):342-3. [PubMed]
9. Park CS, Chung WY, Chang HS. Minimally invasive open thyroidectomy. Surg Today. 2001; 31(8):665-669. [PubMed]
10. Miccoli P, Elisei R, Materazzi G, Capezzone M, Galleri D, Pacini F, et al. Minimally invasive video-assisted thyroidectomy for papillary carcinoma: a prospective study of its completeness. Surgery.2002 Dec;132(6):1070-3. [PubMed] [CrossRef]
11. Bellantone R, Lombardi CP, Raffaelli M, Alesina PF, De Crea C, Traini E, et al. Video-assisted thyroidectomy for papillary thyroid carcinoma. Surg Endosc. 2003 Oct;17(10):1604-8. [PubMed][CrossRef]
12. Ikeda Y, Takami H, Sasaki Y, Takayama J, Kan S, Niimi M. Minimally invasive video-assisted thyroidectomy and lymphadenectomy for micropapillary carcinoma of the thyroid. J Surg Oncol. 2002 Aug;80(4):218-221. [PubMed] [CrossRef]
13. Repplinger D, Bargren A, Zhang YW, Adler J, Haymart M, Chen H. Is Hashimoto's thyroiditis a risk factor for papillary thyroid cancer?. J Surg Research. 2008 Nov;150(1):49-52. [CrossRef].
Accepted for publication: 05 February 2013
Published online: 10 June 2013