new approach for thyroidectomy [isthmus first]: a preliminary study

ABSTRACT

Doing surgery for a huge goiter is always time consuming with difficulty to deliver goiter to the operating field which might increase morbidity. Therefore, this study was carried out to demonstrate a new technique in dealing with huge goiter. A total of 287patients with huge goiter admitted to Al-Ramadi general hospital, Al-Anbar governorate, during Feb. 1993 to Dec. 2002 were included in the study. Two types of surgical techniques were differentiated, the conventional one versus isthmus first. Out of the total patients 133 [46.3%] were underwent conventional thyroidectomy and 154 [53.7%] were underwent isthmus first technique. A significant reduction in operation time in isthmus first than in the conventional one was observed. Significant reduction in postoperative bleeding, temporarily Hypoparathyroidism, and external laryngeal nerve injury was noticed. Simple multinodular goiter, toxic goiter, neoplastic goiter and Hashimato's thyroiditis were the histopathological diagnosis of goiter underwent thyroidectomy in both surgical techniques. Isthmus first provides less operating time and surgical invasiveness and easily handling goiter than the conventional one