ISTHMUS FIRST VERSUS THE CONVENTIONAL APPROACH OF TOTAL THYROIDECTOMY
Keywords:
Thyroidectomy, Isthmus, Conventional, HypocalcemiaAbstract
Background: Thyroid surgery is common worldwide and is increasing due to neck ultrasonography, fine-needle aspiration biopsy, and other environmental factors.
Aim: To compare the outcomes of the isthmus versus the conventional approach of thyroidectomy.
Methods: This prospective randomized study was conducted at AL-Emamein AL-Kadhemein Medical City, Baghdad, Iraq, from the fifth of October 2022 to the twenty-sixth of September 2024. A sample of Two hundred thirty-nine Males and Females was enrolled and divided into two groups, eighty-four patients operated with the isthmus first approach, and 155 patients operated with the conventional approach. The study included ethical considerations, sampling techniques, inclusion and exclusion criteria, data collection, and surgical techniques.
Results: The isthmus-first approach was associated with a significantly lower incidence of transient hypocalcemia (9.5%) compared to the conventional approach (20.0%), with no cases of permanent hypocalcemia in the isthmus-first group. The incidence of voice changes was lower in the isthmus-first approach (6.0%) compared to the conventional approach (12.9%), with statistically significant differences. The isthmus-first approach had a lower incidence of choking (2.4%) compared to the conventional approach (7.7%), with statistically significant differences. The mean operation time for the isthmus-first approach was significantly lower (70.98 minutes) compared to the conventional approach (104.90 minutes). The isthmus-first approach appears to be superior in reducing postoperative complications such as transient hypocalcemia, voice changes, and choking incidents, suggesting better overall patient outcomes.
Conclusion: The study concluded that the isthmus-first approach is superior in reducing operative time, wound size, and postoperative complications and recommended further research with larger sample sizes.
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