The Impact of Uniform Capsular Dissection Technique of Total Thyroidectomy on Postoperative Complications: An Experience of More Than 1000 Total Thyroidectomies from an Endocrine Surgery Training Centre in North India.

Abstract

Background:Total thyroidectomy (TT) with a uniform technique of capsular dissection (CD) is the preferred technique worldwide. The aim of study is to analyze the impact of uniform technique of CD for done as primary surgery at an endocrine surgery training centre.Patients and Methods:Retrospective review from 1995 to 2009. Data collected from hospital records and follow-up.Results:One thousand and thirty-eight cases were included, with mean age 42.91 ± 13.48 years; male:female – 1:2.2; mean duration of goiter – 99.83 ± 105.1 months; 67.8% were euthyroid and 30.7% – hyperthyroid at initial presentation; 35.5% were malignant. Surgery includes TT alone – 77.7% and TT with lymph nodes dissection – 22.3%; sternotomy required in 1.2% and thoracotomy in 0.1%; tracheomalacia present in 3.9%; however, tracheostomy required in 4.5% and parathyroid autotransplantation in 21%; Peroperative mean gross gland weight was 124.34 ± 129.85 g. Complications include hypocalcemia (temporary – 35.9%; permanent – 1.3%); recurrent laryngeal nerve palsy (temporary – 2.7%; permanent – 91%); hemorrhage – 1.3%; and various others.Conclusion:TT with uniform technique of CD is a safe procedure. Certain risk factors may predispose to complications, which can be avoided and managed adequately if anticipated beforehand.