Standard versus video-assisted thyroidectomy: objective postoperative pain evaluation

Background This prospective, randomized study was designed to objectively demonstrate that minimally invasive video-assisted thyroidectomy (MIVAT) improves postoperative pain compared with standard thyroidectomy, via the dosage of biochemical mediators measured before and after surgery. Methods Fort...

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Veröffentlicht in:Surgical endoscopy 2010-10, Vol.24 (10), p.2415-2417
Hauptverfasser: Miccoli, Paolo, Rago, Rocco, Massi, Marco, Panicucci, Erica, Metelli, Maria Rita, Berti, Piero, Minuto, Michele N.
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Sprache:eng
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Zusammenfassung:Background This prospective, randomized study was designed to objectively demonstrate that minimally invasive video-assisted thyroidectomy (MIVAT) improves postoperative pain compared with standard thyroidectomy, via the dosage of biochemical mediators measured before and after surgery. Methods Forty-nine patients undergoing total thyroidectomy were allotted to MIVAT ( n  = 23) or traditional thyroidectomy (OPEN) ( n  = 26) groups. At hospitalization (T0), interleukin (IL)-1, -2, -4, -6, -10, -3, tumor necrosis factor (TNF)-α, TGF-β, and MCP-1 were measured. The basal pain tolerance also was evaluated by VAS. Blood samples for interleukin measurement and VAS evaluations were obtained from all patients in the recovery room (T1) and 24 h after surgery (T2). Results At T0, the MIVAT and the OPEN groups were not different in terms of basal pain tolerance and biochemical profile. At T1, VAS scores were significantly higher ( p  = 0.04), whereas TGF-β ( p  = 0.03) and MCP-1 ( p  = 0.03) levels were significantly lower in the OPEN than in the MIVAT group. No significant difference was demonstrated for other interleukins. A significant inverse relationship between VAS and TGF-β was demonstrated and confirmed through the correlation ( p  = 0.003) and regression ( p  = 0.003, p  
ISSN:0930-2794
1432-2218
DOI:10.1007/s00464-010-0964-7