OUTCOMES OF MICROSCOPIC THYROIDECTOMY COMPARED WITH THE CONVENTIONAL TECHNIQUE: A COMPARATIVE ANALYSIS
Main Article Content
Keywords
MicroscopicThyroidectomy,Recurrent Laryngeal Nerve,Hypocalcemia,ParathyroidPreservation,Thyroid Surgery.
Abstract
Background
Microscopic thyroidectomy offers enhanced magnification and finer tissue handling, which mayreduceintra and post-operative complications compared with the conventionalapproach. Interest inits use has grown as surgeons aim to minimise bleeding,protection against injury to recurrent &superiorlaryngeal nerves, and preserve parathyroid function.
Objectives
To compare postoperative outcomes of microscopic thyroidectomy with the conventional technique,and to evaluate differences between hemi-and total thyroidectomy, as well as benign and malignantthyroid diseases (papillary and follicular carcinoma).
Methods
A comparative study was conducted among 30 patients undergoingthyroidectomy (15 microscopicand15 conventional). Operative time, blood loss, nerve integrity, postoperative hypocalcemia, andsurgical complications were recorded. Subgroup comparisons were made for hemi vs total proceduresand benign vs malignant lesions.
Results
Microscopic thyroidectomy showed lower intraoperative bleeding, clearer identification of recurrentand superior laryngeal nerves, and improved early postoperative calcium stability. Operative time wasslightly longer but associated with improved safety margins.Total thyroidectomy was associated witha higher incidence of transient hypocalcemia compared with hemithyroidectomy,while malignantlesions required wider exposure regardless of technique.
Conclusion
Microscopic thyroidectomy provided more precise dissection and better early postoperative outcomesthan the conventional method. Its advantages were most notable in nerve preservation and parathyroidsafety, making ita valuable option for almost allthyroid surgeries.
References
in benign goitre surgery: prospective multicentre study.Surgery2000;128(6):991-1001.
[2]Rosato L, Avenia N, Bernante P, et al. Complications of thyroid surgery: analysis of a multicentric
study on 14,934 patients.World J Surg2004;28(3):271-6.
[3]Barczyński M, Konturek A, Stopa M, et al. Microscopic identification of the external branch of
the superior laryngeal nerve during thyroidectomy.Laryngoscope2010;120(11):2410-5.
[4]Delbridge L. Total thyroidectomy: the evolution of surgical technique.ANZ J Surg
2003;73(9):761-8.
[5]Shaha AR. Thyroidectomy: conventional technique.Oper Tech Otolaryngol Head Neck Surg
2001;12(3):152-7.
[6]Bergenfelz A, Jansson S, Kristoffersson A, et al. Complications to thyroid surgery: results as
reported in a database from a multicenter audit comprising 3,660 patients.Langenbecks ArchSurg2008;393(5):667-73.
[7]Thomusch O, Machens A, Sekulla C, et al. The impact of surgical technique on postoperative
hypoparathyroidism in bilateral thyroid surgery: a multivariate analysis of 5,846 consecutivepatients.Ann Surg2003;238(3):353-61.
[8]Barczyński M, Konturek A, Cichoń S. Randomized clinical trial of visualization versus
neuromonitoring of the external branch of the superior laryngeal nerve during thyroidectomy.BrJ Surg2009;96(3):240-6.
[9]Gurleyik E, Dogan S. The superior thyroid artery in thyroid surgery: anatomic variations and
surgical importance.J Thyroid Res2014;2014:768391.
[10]Dionigi G, Alesina PF, Barczyński M, et al. Recurrent laryngeal nerve injury in thyroid surgery:
lessons learned from the neuromonitoring era.Gland Surg2017;6(5):537-44.
[11]Friedman M, LoSavio P, Ibrahim H. Superior laryngeal nerve identification and preservation in
thyroid surgery.Arch Otolaryngol Head Neck Surg2002;128(3):296-303.
[12]Randolph GW, Kamani D. The importance of preoperative laryngeal examination in patients
undergoing thyroid or parathyroid surgery.Thyroid2006;16(2):141-6.
[13]Roh JL, Park JY, Park CI. Total thyroidectomy plus neck dissection in differentiated thyroid
carcinoma patients: pattern of nodal metastasis and treatment outcome.Ann Surg Oncol2007;14(3):998-1006.
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Dr. Abhilash S.
Assistant Professor, Department of ENT and Head & Neck Surgery, Farookh Academy of Medical Education Hospital and Research Institute, Mysore, Karnataka, India.
Dr. Sachin H.M.
Assistant Professor,Department of General Surgery, Farookh Academy of Medical Education
Hospital and Research Institute, Mysore, Karnataka, India.
Dr. Ila M.S.
Assistant Professor, Department of Anaesthesiology, G. R. Medical College, Mangalore, Karnataka, India.
