Abstract
To study multinodular goitre patients' surgery by direct observation of surgical technique, and to compare complications with surgeons' skills and experience, for improved training of future thyroid surgeons. Based on positivist epistemology and analytical observational design, this prospective double-blind study of a cohort of multinodular goitre patients operated upon by variedly experienced surgeons, was conducted at Bahawal Victoria Hospital Bahawalpur and Nishtar Medical University Hospital Multan, Pakistan, from December 2016 to April 2019. Patients were admitted through outpatient department and operated upon in routine operation lists. The surgeons were specialists/senior registrars, assistant professors, associate professors and professors. The patients were divided into two virtual groups: the one operated upon by surgeons with >3 years of post-fellowship experience and the other operated upon by surgeons with <3 years of post-fellowship experience. Surgeries were directly observed and differences in surgical technique and complications were recorded for respective groups. Data was analysed using SPSS 20. Of the 134 patients, there were 73(54.5%) in group 1 and 61(45.5%) in group 2. Overall, there were 119(88.8%) females and 15(11.2%) males. The overall mean age was 37.17±13.41 years (range: 14-80 years). Of the 25 surgeons, 13(52%) were in group 1 and 12(48%) in group 2. Group 1 had fewer complications compared to group 2, which on certain parameters was statistically significant (p<0.05). Surgeons' experience and technique were found to have significant relationship with the rate of complications. Direct observation of surgeries is significant for real life evaluation and training of junior surgeons.
Highlights
Emil Theodor Kocher received Nobel Prize in 1909 for his pioneering work in understanding thyroid physiology
Direct observation of surgeries is significant for real life evaluation and training of junior surgeons
The study population comprised a cohort of 134 patients with multinodular goitre (MNG) who were admitted through outpatient department (OPD) on ‘first come first served’ basis
Summary
Emil Theodor Kocher received Nobel Prize in 1909 for his pioneering work in understanding thyroid physiology. Jointly with Theodor Bilroth, established thyroid clinics in Europe and proved safety in thyroid surgery through skilled surgical techniques[1]. Thyroid gland is divided by thin fibrous septae into lobules each composed of 20-40 follicles lined by cuboidal or low columnar epithelium and filled with thyroglobulin. Follicular epithelial cells, under the influence of hypothalamic factor and thyrotropin of anterior pituitary convert thyroglobulin into thyroxin (T4) and lesser amount of tri-iodothyronine (T3)[2]. Multinodular goitre is the most common among the disorders of thyroid gland[3]. Even in non-endemic regions, it is clinically detected in about 4% of adults beyond the age of
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: JPMA. The Journal of the Pakistan Medical Association
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
