Flapless conventional thyroidectomy: A prospective, randomized study

• Published in: Surgery today (Tokyo, Japan) Vol. 40; no. 11; pp. 1018 - 1022
• Main Authors: Kamer, Erdinc, Unalp, Haluk, Derici, Hayrullah, Akguner, Taner, Erbil, Yesim, Issever, Halim, Peskersoy, Mustafa
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01-11-2010
• Subjects: Adult; Aged; Aged, 80 and over; Body Mass Index; Female; Humans; Incidence; Length of Stay - statistics & numerical data; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Pain Measurement; Pain, Postoperative - prevention & control; Postoperative Complications - epidemiology; Postoperative Complications - prevention & control; Prognosis; Prospective Studies; Surgery; Surgical Flaps - adverse effects; Surgical Flaps - statistics & numerical data; Surgical Oncology; Surgical Wound Infection - epidemiology; Surgical Wound Infection - prevention & control; Thyroidectomy - adverse effects; Thyroidectomy - methods; Young Adult; With cutaneous flap; Thyroidectomy; Without cutaneous flap
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-009-4186-3

Purpose
Conventional thyroid surgery is one of the most common operations performed worldwide. The conventional technique involves placement of small or large cutaneous flaps. However, the published data regarding flap use for thyroidectomy are contradictory. This study presents the results using a flapless conventional thyroidectomy and the efficacy of this approach in a thyroidectomy. In addition, the study determined whether there are any advantages associated with the use of this approach in comparison to conventional thyroid surgery.
Methods
One hundred and forty-two patients underwent a thyroidectomy. The patients were randomly assigned to surgical procedures. Patients in Group 1 (
n
= 70) underwent a conventional thyroidectomy, and patients in Group 2 (
n
= 70) underwent a conventional thyroidectomy without a cutaneous flap.
Results
There was no significant difference between the two groups in terms of age, sex, body mass index, length of incision, gland volume, and length of hospital stay. Postoperative pain was significantly less in Group 2 than in Group 1 (
P
= 0.006). Patients in Group 2 showed significantly lower requirement for postoperative intravenous analgesic (
P
= 0.001), and postoperative peroral analgesic (
P
= 0.023) in comparison to those in Group 1. Incidences of transient vocal cord paralysis and hypocalcemia were 1.4% and 1.4%, respectively. Of 140 patients, 5 (3.6%) developed postoperative wound complications.
Conclusions
These results indicate that a flapless thyroidectomy is safe and technically feasible, and therefore could be an alternative to a conventional thyroidectomy.