Minimally invasive video-assisted thyroidectomy

5.1 Overall postoperative morbidity rates (not further defined) of 10% (29/289) and 14% (42/292) were reported for minimally invasive video‑assisted thyroidectomy (MIVAT) and conventional (open) thyroidectomy respectively (pooled odds ratio 0.65, 95% confidence interval 0.387 to 1.091, p=0.544) in a meta-analysis of  9 studies including 581 patients (outcome reported in 7 studies).

5.2 Definitive monolateral recurrent laryngeal nerve palsy was reported in 1% (7/833), 2% (5/300) and 2% (2/116) of patients in case series of 833, 300 and 116 patients treated with MIVAT respectively.

5.3 Superior laryngeal nerve injury was reported in 2% (5/300) of patients in the case series of 300 patients.

5.4 Postoperative bleeding that needed reoperation was reported in less than 1% (1/833) and 4% (5/116) of patients in the case series of 833 and 116 patients respectively.

5.5 Wound sepsis was reported in less than 1% (2/833) of patients in the case series of 833 patients.

5.6 Permanent hypoparathyroidism was reported in 6% (2/34) of patients treated by MIVAT and 6% (4/65) of patients treated by conventional thyroidectomy in a non‑randomised comparative study of 99 patients. Severe symptomatic hypoparathyroidism was reported in 2% (2/116) of patients in the case series of 116 patients.

5.7 Transient postoperative hypocalcaemia was reported in 4% (12/289 and 11/292) of patients treated by either MIVAT or conventional thyroidectomy respectively (p=0.9) in the systematic review of 9 studies including 581 patients (outcome reported in 5 studies). Permanent hypocalcaemia needing substitutive therapy was reported in less than 1% (2/510 total thyroidectomies) of patients in the case series of 833 patients.

5.8 A skin burn was reported in 2% (5/300) of patients in the case series of 300 patients.

5.9 The specialist advisers listed the additional adverse event of neck haematoma.