Endoscopic Thyroidectomy for Benign Thyroid Lesions: A Prospective Study

ABSTRACT

Thyroidectomy is one of the most common operations performed throughout the world, with solitary thyroid nodules being one of the more common indications for surgery. Though conventional open thyroidectomy is considered extremely safe and remains the treatment of choice, it is associated with an undesirable scar. Endoscopic thyroidectomy has the distinct advantage of limiting external scarring and having better cosmetic results. It moreover is associated with reduced post-operative pain, and enhanced postoperative recovery. Methods: It was a hospital based non randomized prospective descriptive study carried out in department of general surgery at tertiary hospital in which 39 patients with benign thyroid lesions were included on the basis of a predefined inclusion and exclusion criteria. Detailed history, clinical and local examination was done in all the cases. Thyroid function tests, FNAC under ultrasound guidance, indirect laryngoscopy and imaging of thyroid gland was done in all the cases. All patients underwent endoscopic thyroid surgery (Total, near total, subtotal or hemithyroidectomy). Patients were followed up for 6 months after surgery. P value less than 0.05 was taken as statistically significant. Results: Out of 39 studied cases there were 35 males and 4 females with a MF ratio of 18.75. Most common age group was found to be 30-40 years with a mean age of 32 yrs. Average size of thyroid nodule was 3.20 cms and right lobe was predominantly involved (69.23%). Predominant Pathology on FNAC was found to be colloid goiter (71.79%). All patients underwent endoscopic thyroidectomy. Mean duration of surgery was 55 minutes. Most common surgery undertaken was hemithyroidectomy (84.62%) followed by total thyroidectomy (10.16%) and completion total thyroidectomy (5.13%). Average total blood loss was significantly less (36 ml). Mean visual analogue score at 24 and 48 hours post-operatively were 4.14 and 2.85. Mean duration of hospital stay was 3.3 days. Majority of the patients (89.75%) were extremely satisfied with the cosmetic results. Conclusion: Endoscopic thyroidectomy for Benign thyroid lesion is associated with less blood loss during surgery, comparatively less severe pain, decreased mean duration of hospital stay and satisfactory cosmetic results.