Minimally invasive video-assisted thyroidectomy: report of 16 cases in children older than 10 years.

METHODS From October 1998 to December 2002 in the Department of Surgery at the University of Pisa, 16 patients ages 18 years or younger (14 girls, 87.5%, and 2 boys, 12.5%; range, 11 to 18; mean age, 15 years, 8 months) underwent a surgical operation with video-assisted technique for thyroid pathology. These patients belong to a larger group of 270 patients treated with this technique. Surgical therapy with video-assisted technique was chosen; a lobectomy was used in 15 cases (90.0%) and a total thyroidectomy in 1 case (10%). RESULTS Two patients (12.5%) underwent a second video-assisted operation to complete the thyroidectomy for a false-negative result at extemporal histologic examination during the first operation. The histologic examination found benign pathology in 14 cases (87.5%) and a malignant lesion (papillary type) in 2 cases (12.5%). No postoperative complications were observed. CONCLUSIONS The results of the mini-invasive video-assisted technique for thyroidectomy in this preliminary experience seem to be equal to those of the traditional open surgical technique (200 surgical operations for thyroid pathology for the ages 18 years or younger). Elective indications of the mini-invasive video-assisted technique are the volume of the nodule and hystological type; this technique cannot be used in cases of voluminous goiter, medullary carcinomas and poorly differentiated carcinomas. The advantage that this technique offers, in addition to a better postoperation period, is an improved esthetic result, which is particularly important in young patients.