Abstract

OUTCOME OF CAPSULAR DISSECTION USING MONOPOLAR CAUTERY IN THYROIDECTOMY- A RETROSPECTIVE STUDY

Author(s): Rajesh T. R.1, Santhosh T. V.2

BACKGROUND The main post-operative complications of thyroidectomy are temporary hypocalcaemia (20%), permanent hypocalcaemia (4%), transient vocal cord palsy (1-2%) and permanent vocal cord palsy (0.5-1%). These complications are less with experienced surgeons using capsular dissection technique. The technique of capsular dissection can be done with the conventional technique or using other energy sources. Our study aims to find the outcome of capsular dissection using monopolar cautery. We wanted to study the outcome of capsular dissection technique, using monopolar cautery, during thyroid surgery, with regard to complications, bleeding and time taken for the procedure. METHODS This is a retrospective study conducted in the Department of Surgery, Government Medical College, Thrissur. Details of patients undergoing thyroidectomy by capsular dissection technique, using monopolar cautery, during the period 2012 to 2015 were collected. Collected data was subjected to statistical analysis with the help of SPSS Ver. 21.0. Basic statistical methods like percentage analysis is used for analysis of data. RESULTS 115 patients who underwent thyroidectomy for varying indications during the period and satisfying the inclusion criteria were included in the study. All patients were operated under general anaesthesia. All surgeries were done by the same surgeon, by capsular dissection technique using monopolar cautery. Average time duration was 79 minutes for total and 60 minutes for hemi-thyroidectomy. Blood loss was less than 30 ml. in all patients. There was no mortality. Overall complication rate was 5.2%. Transient hypocalcaemia was 3.4%, temporary hoarseness was 2.2% and wound haematoma was 0.8%. CONCLUSIONS Capsular dissection using monopolar cautery in thyroidectomy is safe and effective. This technique is less time consuming, causes only minimal bleeding and has lower complication rate.