Modifying The Technique Of Open Thyroidectomy Without Myocutaneous Flaps ALIRIO MIJARES BRIÑEZ MD! !

VENEZUELA

Types of Thyroidectomy

CARMEN MARIA SUAREZ MD

Pathologic Outcomes OBJECTIVES: To evaluate if modifying the technique of open thyroidectomy, we can get better cosmetic, less surgical time and less complications METHODS: A total of 224 patients were included in this prospective, descriptive study, conducted from January 2004 to January 2014, a total of 110 traditional thyroid approaches and 144 approaches midline, made in the La Floresta Medical Institute and Medical Center La Trinidad in Caracas, Venezuela.

RESULTS: There was not diferentes in pain, ! cosmetic satisfacción or the hospital stay, ! but greather number of complications in viewed traditional procedure than ! modified technique. We have seen less surgical time, it has been statistical significance.

Nodular Hyperplasia Thyroid adenoma Multinodular Goiter Papillary Microcarcinoma Follicular Carcinoma Grave´s Disease Post Radiotherapy adenoma Papillary Carcinoma Parathyroid Hyperplasia

LOBECTOMY AND ISTMECTOMY ! ! ! 35,7 %! TOTAL THYROIDECTOMY!! ! ! 53,5 %! PARATHYROIDECTOMY! ! ! ! 2 %! THYROIDECTOMY PLUS NECK DISSECTION! 8,8 %

Haematoma True vocal-fold paresis Complications Transitory Hypoparathyroidism Seromas

CONCLUSIONS: The midline approach technique, separating the pre thyroid muscles ! in the middle line after opening the platysma muscle of the neck without make ! myocutaneous flaps top and bottom, is simple, easy to use, low incidente of ! bleeding to use and it has shorter surgical time and less post operative complications.

REFERENCES:

Sosa J, Bowman H, Tielsch J, Powe N, Gordon T, Udelsman R. The importance of surgeon experience for clinical and economic outcomes from thyroidectomy. Ann Surg. 1998;228(3):320-330. Ros S, Gómez JR, Gómez L, Ejido R, Pelayo A. Tiroidectomía selectiva utilizando vía lateral. Estudio comparativo. Gland Tir Paratir. 2005;(14):20-24. Mijares A, Suarez C, Pérez C, Pacheco C. Uso del bisturí armónico en la cirugía tiroidea. Rev Venez Oncol. 2006;18(4):215-220. Filho JG, Kowalski LP. Surgical complications after thyroid surgery performed in a cancer hospital. Otolaryngol Head Neck Surg. 2005;132(3):490-494. Stadelmann WK, Digenis AG, Tobin GR. (1998). Physiology and healing dynamics of chronic cutaneous wounds. Am J Surg. 1979;176(2A Suppl):26-38.