Description

Introduction: Thyroidectomy is the commonest endocrine surgical procedure undertaken throughout the world. Although it is one of the most frequently performed surgical procedure worldwide, it was during the last century that, it become an accepted operation. Objective: The aim of this study was to observe the outcome of thyroid surgery by lateral approach. Materials and Methods: A Prospective Study Department of ENT, Rajshahi Medical College Hospital, Rajshahi, Bangladesh during from July 2017 to December 2019. A total number of 218 cases of thyroid surgeries were performed using this procedure. Simple random sampling technique. Detailed history was taken and ever patient was examined thoroughly specially focusing on the neck. All patients were done USG of the neck, Fine needle aspiration cytology (FNAC) and thyroid function test. All procedures were done by a single surgeon. Results: In our study among 218 cases 177 cases were female and rest are male. 81.19 % of our study subjects were female and male to female ratio 1:4.3(TGBE1), age ranges from 10-70 years, mean age 38.5±8.10, most of the patients belongs to 31-40 years of age. Rest of 139 were benign thyroid diseases. This group most common age group 31-40 years. 138 cases were benign thyroid lesion which were nodular goiter (63.30 %) follicular adenoma (0.031 %), Toxic MNG (0.0181 %), 79 cases of carcinoma thyroid among which 74 were papillary ca thyroid (33.94 %), 02 were follicular carcinoma (0.009 %) and 03 were medullary carcinoma (0.0131 %). 79 were malignant, 28 patients had lymph node metastasis. Patients with benign thyroid lesion underwent 34 hemithyroidectomy for nodular goiter (15.59%), 8 hemithyroidectomy for follicular adenoma (0.036%) multinodular goiter involving both lobe of thyroid done total thyroidectomy was 92 (42.20 %). PTC underwent total thyroidectomy with central neck dissection 40 (18.34 %), total thyroidectomy with CND + SND (level II to IV) 23 cases (10.55%), total thyroidectomy with CND +Bilateral MRND 02 cases (0.009%), and completion thyroidectomy 8 cases (0.036 %), 4 cases of follicular carcinoma done total thyroidectomy with CND (0.0183 %) and 4 cases of toxic MNG done total thyroidectomy (0.0183 %).In our study most common complication war temporary para-thyroid insufficiency 47 cases (4.14%), and permanent parathyroid insufficiency 2 cases (0.011%), up to one year follow up. Conclusion: Lateral approach to thyroid is a safe alternative to the standard approach for re-explorative thyroid surgery. Lateral approach to thyroid is an alternative to both conventional thyroidectomy and for parathyroid explorations.

Keywords: Lateral approach, Re-operative, Thyroid