Parimuthukumar Rajappa, MS, Prashanth Krishna, Apoorva Prathap, Vishwanath Pai. Sri Ramachandra University, Chennai, India
INTRODUCTION: Minimally invasive techniques have replaced open surgery in many surgical fields. Endoscopic Transaxillary Thyroidectomy is one such technique that may provide superior cosmetic results for patients needing thyroidectomy.
METHODS AND PROCEDURES: All patients undergoing hemithyroidectomy (open and endoscopic) for solitary thyroid nodules for a period of 5 years in the Department of General Surgery, Sri Ramachandra University, were included in the study.
All solitary thyroid nodules of size 5 cm or less in patients 18 years or above of age were included in the study. Recurrent nodules and patients with ASA > 3 were excluded.
All patients included in the study were subjected to one of the surgeries mentioned earlier. Of 171 patients, 78 underwent transaxillary endoscopic hemithyroidectomy and 93 patients underwent traditional open thyroidectomy selected randomly. 12F suction drain was placed in both groups. Duration of surgery was documented in all cases. Post-operative pain score was recorded on post-op day 1,3 and 7 using visual analog scale.Post-operative drain value, seroma, recurrent laryngeal nerve damage and duration of hospital stay were also studied. Patients’ postoperative histopathology reports were followed. All patients were followed up post-operatively for a period of 6 months.
RESULTS: Total operating time was calculated from the time of skin incision to closure. Mean operating time in transaxillary endoscopic group is 132 minutes and in open hemithyroidectomy group is 102.03 minutes.
Mean duration of stay in open hemithyroidectomy group is 3.84 days while in transaxillary endoscopic thyroidectomy group it is 2.42 days.
There is significant reduction in postoperative pain in transaxillary endoscopic hemithyroidectomy as compared to open group. Pain score was documented on POD 1, 3 and 7 using visual analog scale.
CONCLUSION: Transaxillary endoscopic thyroidectomy is superior to conventional open hemithyroidectomy in terms of postoperative pain, duration of stay, seroma formation and cosmesis in our study.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 78700
Program Number: S154
Presentation Session: Minimally Invasive Surgery – World Tour
Presentation Type: Podium