Abstract
The focal point of thyroidectomy surgery has always been to reduce the incidence of inadvertent damage to the recurrent laryngeal nerve(RLN). The intracapsular thyroidectomy is one such technique with minimum chance of injuring the nerve. To compare retrospectively the surgical outcomes between the two methods of thyroidectomy—coventional thyroidectomy Vs intracapsular thyroidectomy. Materials and methods—55 cases of benign thyroid disease for whom thyroidectomy was performed in our hospital between the period of 2019–2022 were compared retrospectively. Out of these 34 cases had undergone intracapsular thyroidectomy and 21 cases underwent routine extracapsular thyroidectomy. The surgical outcomes including operation time, pain, postoperative infection, postoperative hypocalcemia, postoperative recurrent laryngeal nerve paralysis and mean hospital stay were analyzed. The mean operating time were very low in the intracapsular limb as compared to the other group. The pain and the mean hospital stay was also far lesser for the intracapsular limb. Both cohorts had no incidence of hypocalcemia. The incidence of recurrent laryngeal nerve palsy was very low in the intracapsular cohort (only 1 case of temporary unilateral RLN palsy), whereas it was higher in the routine extracapsular cohort (5 cases of permanent palsy). The risk of having vocal cord palsy (left/right) is 1.172 times more with conventional/standard thyroidectomy as compared to intracapsular thyroidectomy. Intracapsular technique is a much more rewarding method to perform thyroidectomy, without the risk of the recurrent laryngeal nerve palsy as compared to routine thyroidectomy.
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Data was obtained retrospectively form the case sheets and patients attending the ENT and General Surgery department of Sree Balaji Medical College and Hospital.
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Acknowledgements
I thank the management of my medical college, Heads of Department of ENT and General Surgery and the postgraduates of these two departments who supported me with the work for this paper. Dr. Mohan Kumar.J—Senior resident, Dr. Vivek Raajan—Senior resident, Dr. Nishanth—Junior resident, Dr.Muralidharan—Junior resident, Dr. Jayakanthan –Asst Prof. General surgery, Ms. Sandhya—secretary, Dr. Mohammed Illiyas—cardiologist, Ms Ashni—Statistician.
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SM did most of the writing of the article, performed the surgeries, compiled the data for the article from ENT and General Surgery departments, collected literature review and researched similar articles for the same. MKR gave the framework of the study with the idea for the comparison and the methods of study as well as helped with the writing of the manuscript. He also helped with procurement of data and its compilation from the General surgery department. SR helped with obtaining the ethical clearance and patients consent, proofreading, corrections and references for the article. All authors read and approved the final manuscript.
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The ethical approval for this study was obtained from the Institutional Ethics Committee of Sree Balaji Medical College and Hospital. The authors assert that all the procedures contributing to the present work comply with the ethical standards of the relevant national and institutional guidelines on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. Informed written consent—to use their case data and their intraoperative pictures was obtained from the patients when they came in for their postoperative visits (since this was a retrospective study we embarked on).
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Meenakshi, S., Rajasekar, M.K. & Ramanathan, S. Retrospective Cohort Study on the Surgical Outcomes of Intracapsular Thyroidectomy Vs Standard Thyroidectomy. Indian J Otolaryngol Head Neck Surg 75, 3792–3797 (2023). https://doi.org/10.1007/s12070-023-04074-9
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DOI: https://doi.org/10.1007/s12070-023-04074-9