 |
|
Incision Length for Standard Thyroidectomy and Parathyroidectomy
When Is It Minimally Invasive?
Laurent Brunaud, MD;
Rasa Zarnegar, MD;
Nobuyuki Wada, MD;
Philip Ituarte, PhD;
Orlo H. Clark, MD;
Quan-Yang Duh, MD
Arch Surg. 2003;138:1140-1143.
Hypothesis Current techniques for open conventional thyroidectomy or parathyroidectomy have evolved to enable a shorter incision (main proposition), and the length of the incision is influenced by objective factors.
Design Case series.
Setting University referral center.
Patients and Intervention Retrospective study of the most recent 200 primary consecutive routine thyroid and parathyroid operations (excluding neck dissections).
Main Outcome Measures The length of incision was routinely measured with a ruler before the incision. Univariate and multivariate analysis was performed to distinguish variables affecting length of incision.
Results Mean length of the incision was 5.5 cm for total thyroidectomy, 4.6 cm for lobectomy, and 3.5 cm for parathyroidectomy (P<.001). It was 4.1 cm for bilateral parathyroid exploration, but was reduced to 3.2 and 2.8 cm for unilateral (P<.001) and focal (P<.001) explorations, respectively. By multiple regression analysis, thyroid specimen volume and patient body mass index were independent predictors of incision length in thyroidectomy. Extent of exploration and resident training level were independent predictors of incision length in parathyroidectomy.
Conclusions Current techniques for open conventional thyroidectomy or parathyroidectomy have evolved to enable a shorter incision. Thyroid volume, patient body mass index, extent of the planned parathyroid exploration, and the resident clinical training stage are important variables for incision length in open operation and should be taken into account when minimally invasive thyroidectomy and parathyroidectomy are evaluated.
From the Departments of Surgery, University of California, San Francisco (Drs Brunaud, Zarnegar, Wada, Ituarte, Clark, and Duh), and Mount Zion Medical Center, San Francisco (Drs Brunaud, Zarnegar, Wada, Ituarte, and Clark); and Surgical Service, Veterans Affairs Medical Center, San Francisco (Dr Duh). Dr Brunaud is now with the Department of General and Endocrine Surgery, University of Nancy, Brabois, France.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Objective and Subjective Scar Aesthetics in Minimal Access vs Conventional Access Parathyroidectomy and Thyroidectomy Surgical Procedures: A Paired Cohort Study
O'Connell et al.
Arch Otolaryngol Head Neck Surg 2008;134:85-93.
ABSTRACT
| FULL TEXT
Minimally Invasive Surgery or Minimal-Incision Thyroidectomy?
Ng
Arch Surg 2004;139:802-802.
FULL TEXT
|
