Abstract
Background and Objective:Surgical managements for these suspicious nontoxic swellings requires open conventional method of thyroidectomy by neck incisions that can result in prominent scars and immediate risk usually hemorrhage. However new technological innovations came into practiced that include video assisted minimal invasive endoscopy by axillo-breast approach that gives very promising results with excellent cosmesis. In this study, we compared conventional open surgery with minimal invasive endoscopic techniques and associate various complaints and complications that were encountered in surgery.Methods:Sixty patients were enrolled in this comparative study. It was conducted from period February 2018 to February 2019. The patients were randomized alternatively in two groups. Group-I patients underwent conventional lobectomy while Group-II patients were operated endoscopically, Patients having nodules less than 3cm and Thy 1 and 2 were included in this study. Patient having nodules greater than 3cm, Multinodular goiter, recurrent nodule and Thy 3-6 were excluded from the study.Results:Patients who underwent endoscopic lobectomy were much more satisfied about scar marks whereas some developed post-operative complications. It included hoarseness of voice in Three (13.62%) patients, two patients developed seroma (9.08%), three patients (13.62%) erythema, whereas no postoperative complications were seen in patients who underwent open thyroid lobectomy. No signs of hypocalcemia noted in both approaches.Conclusions:The complications with endoscopic approaches are higher but they are minor and resolved spontaneously within maximum period of six weeks. However scar mark satisfaction was much higher in endoscopic lobectomy group.
Highlights
Thyroidectomy that is surgical removal of all or part of the thyroid gland may be accomplished for several clinical indications that include malignancy, benign nodules or cysts, suspicious findings on fine needle aspiration biopsy, dysphagia from cervical esophageal compression, or dyspnea from airway compression
The Technological innovation of videoassisted minimally invasive surgery in this era had outstretched the successful attempt by endoscopic thyroidectomy
Sixty (60) patient who underwent open and endoscopic thyroid lobectomy out of which 30 patients went through open approach and 30 went through endoscopic approach from period of February 2018 to February 2019
Summary
Thyroidectomy that is surgical removal of all or part of the thyroid gland may be accomplished for several clinical indications that include malignancy, benign nodules or cysts, suspicious findings on fine needle aspiration biopsy, dysphagia from cervical esophageal compression, or dyspnea from airway compression. Thyroid surgery rates have tripled over the past three decades.[1] With further advancement minimally invasive thyroid surgeries have evolved over the past decade and several techniques have been exploited to avoid neck scarring Among these are axilla-breast endoscopic approaches, gasless axillary approach, trans oral robotic approaches postauricular facelift approach, and transoral vestibular approach.[2] the Technological innovation of videoassisted minimally invasive surgery in this era had outstretched the successful attempt by endoscopic thyroidectomy. These are the most preferred as they are related to insignificant pain, minimal tissue trauma, minor wound related complications, shortens hospital stay and draws a great deal of responsiveness because of its cosmetic excellence.[3]. Scar mark satisfaction was much higher in endoscopic lobectomy group
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