Thyroidectomy by lateral approach our experience of 218 cases
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20203188Keywords:
Lateral approach, Thyroidectomy, Parathyroid, RLNAbstract
Background: Thyroidectomy is one of the most frequently performed surgical procedure worldwide. During the last century, it became an accepted operation. The aim of the study was to observe the outcome of thyroid surgery by lateral approach.
Methods: A prospective study was conducted in department of ENT, National institute of ENT, Tejgaon, Dhaka, Bangladesh from July 2015 to June 2019. A total number of 218 patients of thyroid surgeries were selected as a study sample by simple random sampling technique.
Results: In our study, male to female ratio was 1:4.3 with an age ranges from 10-70 years. Mean age was 38.5±8.10 years. Among the participants, 80 were carcinoma thyroid and 138 were benign thyroid diseases. Out of 138 benign thyroid lesions, nodular goitres were 126 (91.30%), follicular adenoma were 8 (5.79%), and toxic MNG were 4 (2.89%). Among 80 cases of carcinoma thyroid, papillary carcinoma were 75 (93.75%), follicular carcinoma were 2 (2.57%) and medullary carcinoma were 3 (3.75%). 28 patients of carcinoma thyroid presented with neck node metastasis. We could identify 382 (98.96%) of recurrent laryngeal nerves (RLN). Temporary paresis of RLN were 16 (4.16%), permanent RLN palsy was 03 (0.78%). Temporary parathyroid insufficiency were 47 (27.97%), permanent insufficiency were 2 (1.19%) up to one year follow up.
Conclusions: Lateral approach to thyroid is a safe alternative to the standard approach for re-explorative thyroid surgery. Lateral approach to thyroid is an alternative to both conventional thyroidectomy and for parathyroid explorations.
References
Serpel JW, Lee JC, Yeung MJ, Grodski S, Johnson W, Bailey M. Differential recurrent laryngeal nerve palsy rates after thyroidectomy. Surgery. 2014;156(5):1157-66.
Kasemsuwan L, Nubthuenetr S. Recurrent laryngeal nerve paralysis: a complication of thyroidectomy. J Otolaryngol. 1997;26(6):365-7.
Sarkar S, Banerjee S, Sarkar R, Sik DB. A Review on the H istory of ‘Thyroid Surgery’. Indian J Surg. 2016;78(1):32-6.
Udelsman R. Experience counts. Ann Surg. 2004;240:26-7.
Ito Y, Iwase H, Tanaka H, Yuasa H, Kureyama Y, Yamashita H, et al. Metachronous primary hyperparathyroidism due to a parathyroid adenoma and a subsequent carcinoma: report of a case. Surg Today. 2001;31:895-8.
Hermann M, Hellebart C, Freissmuth M. Neuromonitoring in thyroid surgery: prospective evaluation of intraoperative electrophysiological responses for the prediction of recurrent laryngeal nerve injury. Ann Surg. 2004;240:9-17.
Zambudio AR, Rodriguez J, Riquelme J, Soria T, Canteras M, Parrilla P. Prospective study of postoperative complications after total thyroidectomy for multinodular goitres by surgeons with experience in endocrine surgery. Ann Surg. 2004;240:18-25.
Giddings AE. The history of thyroidectomy. J R Soc Med. 1998;91(33):3-6.
Alaa M. Lateral approach to attack superior thyroid vascular pedicle eliminates the need for strap muscles cutting during thyroidectomy. Med J Cairo Univ. 2015;83:125134.
Dissanayake DDMC, Fernando RF, Dissanayake IJ. Lateral approach to thyroid: a good technique for re-operative thyroid surgery. World J Endocr Surg. 2016;8(2):141-2.
Oertli Surgery of the Thyroid and Parathyroid Glands Springer; 2012.
Palazzo FF. Endocrine surgical technique: endoscopic thyroidectomy via the lateral approach. Surg Endosc Other Interv Tech. 2006;20:339-42.
Sebag F, Palazzo FF, Harding J. Endoscopic lateral approach thyroid lobectomy: safe evolution from endoscopic parathyroidectomy. World J Surg. 2006;30(5):802-5.
Giannopoulos G, Kang SW, Jeong JJ. Robotic thyroidectomy for benign thyroid diseases: a stepwise strategy to the adoption of robotic thyroidectomy (gasless, trans axillary approach). Surg Laparosc Endosc Percutan Tech. 2013;23(3):312-5.
Kiriakopoulos A, Linos D. Gasless trans axillary robotic versus endoscopic thyroidectomy: exploring the frontiers of scar less thyroidectomy through a preliminary comparison study. Surg Endosc. 2012;26(10):2797-801.
Henry JF, Sabag F. Lateral endoscopic approach for thyroid and parathyroid. Chir. 2006;131:51-6.
Napolitano C, Vix M, Mutter D, Marescaux J. Thyroid and parathyroid surgery: is the medial approach truly elective? Technique and advantage of the lateral approach. Minerva Chir. 1997;52(11):1393-5.
Henry JF, Sebag F. Lateral endoscopic approach for thyroid and parathyroid surgery. Ann Chir. 2006;131(1):51-6.
Lombardi CP, Raffaelli M, D’alatri L. Voice and swallowing changes after thyroidectomy in patients without inferior laryngeal nerve injuries. Surgery. 2006;140(6):1026-34.
Yan HX, Pang P, Wang FL, Tian W, Luo YK, Huang W, et al. Dynamic profile of differentiated thyroid cancer in male and female patients with thyroidectomy during 2002013 in China, a retrospective study. Sci Rep. 2017;7:15832.
Huang CF, Jeng Y, Chen KD, Yu JK, Shih CM, Huang SM, et al. The pre-operative evaluation prevents the post-operative complications of thyroidectomy. Ann Med Surg (Lond). 2015;4:5-10.
Vanderpump MP. The epidemiology of thyroid disease. Br Med Bull. 2011;99:39-51.
Bourrel C, Uzzan B, Tison P, Despreaux G, Frachet B, Modigliani E, et al. Transient hypocalcemia after thyroidectomy. Ann Otol Rhinol Laryngol. 1993;102:496-501.
Abboud B, Sargi Z, Akkam M, Sleilaty F. Risk factors for post-thyroidectomy hypocalcemia. J Am Coll Surg. 2002;195:456-61.
Seo ST, Chang JW, Jin J, Lim YC, Rha KS, Koo BS. Transient and permanent hypocalcemia after total thyroidectomy: Early predictive factors and long-term follow-up results. Surgery. 2015;158:1492-9.
Suwannasarn M, Jongjaroenprasert W, Chayangsu P, Suvikapakornkul R, Sriphrapradang C. Single measurement of intact parathyroid hormone after thyroidectomy can predict transient and permanent hypoparathyroidism: A prospective study. Asian J Surg. 2017;40:350-6.
