Chate Niteen Narayanrao1, Salve Pramod Govindrao2, Avadhut Narayanrao Dange3, Anup Sarda4
ABSTRACT: INTRODUCTION: The conventional technique of thyroidectomy for solitary thyroid nodule requires long skin incision, not satisfying patient and surgeon in terms of cosmesis and endoscopic thyroid surgery requires expertise. In our study, minimal incision thyroid surgery was done through a small unilateral focused neck incision that optimizes both access and cosmesis. THE AIM OF STUDY: Is to evaluate the advantages and disadvantages of thyroidectomy through a minimal incision. METHODS: Prospective case control study from January 2010 to September 2012, in 100 patients with solitary thyroid nodule. Exclusion criteria: multi nodular goitre, malignancy, previous neck surgery and radiotherapy. Patients were divided into two groups, 1st group 50 patients operated using minimal incision and 2nd group 50 patients using conventional incision. Pain and analgesic requirement, operative time, incision length, postoperative complications and cosmesis were compared. RESULTS: Both groups were comparable on epidemiological parameters. Operative time ranges from 66.30±11.19 minutes in 1st group and 89.30±9.58 minutes in 2nd group. The mean incision lengths in 1st and 2nd group were 3.328±0.36 cm and 7.95±0.54 cm respectively. The size and volume of specimen was 3-4 cm and <40 ml in both groups. The mean visual analog scale (VAS) score for pain in 1st and 2nd group were 49.10±8.85 and 59.00±8.33 respectively. The mean numerical score system (NSS) cosmetic outcome score in 1st and 2nd group were 6.56±0.81 and 4.82±0.85 respectively. Drain requirement, nil in 1st group and 22% in 2nd group. CONCLUSION: Minimal incision thyroidectomy is safe and feasible in selected cases, with excellent cosmetic outcome, with minimal learning curvature.