Comparative analysis of conventional and video-assisted surgeries on thyroid and parathyroid glands

Aim. A comparative analysis of conventional and video-assisted operations effectiveness.

Methods. The study included 80 patients were operated from 2010 to 2015 for thyroid and parathyroid glands diseases. The first (main) group included 35 patients who underwent video-assisted surgery. The second group (comparison group) included 45 patients who were operated conventionally. Surgery for thyroid gland diseases included hemithyroidectomy, for diseases of the parathyroid glands - parathyroidectomy in patients with tertiary hyperparathyroidism and adenoma resection in patients with primary hyperparathyroidism.

Results. In video-assisted hemithyroidectomy, mean surgery duration was 42.2±3.6 min, compared to 34.4±2.8 min (p=0.086) in conventional method. Recurrent laryngeal nerve and parathyroid glands were identified in 73% of cases at conventional surgery, compared to 96% at video-assisted hemithyroidectomy (p=0.012). At video-assisted surgeries, no phonation disorders were recorded, while at conventional surgeries they were diagnosed in 7 patients (14.0%, p=0.041). Transient hypocalcemia according to the results of laboratory tests was observed in 1 (3.3%) patients after video-assisted and in 3 (6.0%) patients after conventional surgery (p=0.998). The average length of hospital stay after conventional surgery was 8.1±1.8 days, and after video-assisted surgery - 2.6±1.6 days (p=0.040). Postoperative scar size in the group of video-assisted surgery not exceeded 3 cm, in the group of conventional surgery - up to 7 cm.

Conclusion. With proper selection of patients, particularly with parathyroid gland diseases, are video-assisted surgery might be a method of choice. Using video-assisted surgery in treating patients with thyroid gland diseases allows to identify anatomical structures of the neck in detail.