Comparative Study between Backdoor and Conventional Thyroidectomy in Non-Recurrent Goiter

Abstract

Background: Thyroidectomy is the most common endocrine surgery. The traditional procedure of thyroidectomy is through midline splitting of strap musculatures. The Backdoor approach of thyroidectomy is an established method to explore thyroid and parathyroid lesions. Objective: To evaluate how safe and feasible is the backdoor approach for thyroidectomy and to compare its results with the conventional thyroidectomy technique. Patients and methods: This prospective study was conducted at Mansoura University Hospitals. We included 40 cases with benign non-recurrent goiter who were divided into 2 equal groups; group “A” included 20 cases who underwent the conventional procedure, and group “B” which included the remaining 20 cases who underwent the backdoor procedure. Results: Regarding the early post-operative period, the backdoor group (group B) experienced less post-operative pain scores and thus, less need for analgesic requirement (1.67 vs. 3.76 for the other group – p = 0.017). One case (5%) in group A was complicated by hematoma and was managed via surgical exploration. Both groups had the same range of hospital stay after the operation (2 days). Superficial surgical site infection was diagnosed in one case (5%) in each group. Transient post-operative hypocalcemia was encountered in 5 cases (25%) in group A and 2 cases (10%) in group B (p = 0.179). Conclusion: Based on our study findings, it was evident that back door thyroidectomy has more advantages compared to the conventional approach including: Less post-operative pain as peritracheal fascia is not closed, easy identification of parathyroid glands and recurrent laryngeal nerve and avoidance of recurrent laryngeal nerve injuries.