Factors influencing the length of the incision and the operating time for total thyroidectomy

Consorti, Fabrizio; Milazzo, Francesca; Notarangelo, Mariagiovanna; Scardella, Laura; Antonaci, A

doi:10.1186/1471-2482-12-15

Cited by 14 publications

(22 citation statements)

References 15 publications

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“…For example, Consorti and colleagues examined the factors influencing operating time for total thyroidectomy. They found that factors such as thyroid volume or neck circumference explained very little of the variance in operative time (39). Increased gland size is traditionally viewed as a factor contributing to difficulty.…”

Section: Discussionmentioning

confidence: 99%

Novel Thyroidectomy Difficulty Scale Correlates with Operative Times

et al. 2014

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Introduction The aim of this study was to evaluate a new thyroidectomy difficulty scale (TDS) for its inter-rater agreement, correspondence with operative times, and correlation with complications. Methods We developed a four item, 20-point TDS. Following cases where two board-certified surgeons participated, each surgeon completed a TDS, blinded to the other’s responses. Paired sets of TDS scores were compared. The relationship between operative time and TDS scores was analyzed with linear regression. Multiple regression evaluated the association of TDS scores and other clinical data with operative times. Results A total of 119 patients were scored using TDS. In this cohort, 22.7% suffered from hyperthyroidism, 37.8% experienced compressive symptoms, and 58.8% had cancer. The median total TDS score was 8, and both surgeons’ total scores exhibited a high degree of correlation. 87.4% of both raters’ total scores were within one point of each other. Patients with hyperthyroidism received higher median scores compared to euthyroid patients (10 vs. 8, p<0.01). Similarly, patients who suffered a complication had higher scores compared to those patients without complications (10 vs. 8, p= 0.04). TDS scores demonstrated a linear relationship with operative times (R2 = 0.36, p<0.01, Figure 1). Cases with a score of 14 or greater took 41.0% longer compared to cases with scores of five or less (p<0.01). In multiple regression analysis, TDS scores independently predicted operative time (p<0.01). Conclusion The TDS is an accurate tool, and scores correlate with more difficult thyroidectomies as measured by complications and operative times.

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Section: Discussionmentioning

confidence: 99%

Novel Thyroidectomy Difficulty Scale Correlates with Operative Times

et al. 2014

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“…This study did not examine the trauma of skin edges during thyroidectomy as a potential risk factor for hypertrophic scarring. However, these and other authors have highlighted the importance of avoiding excessive retraction, trauma or thermal injury to the skin edges during the execution of the operation in order to achieve a better cosmetic result 4,5,8,10,11 . To our knowledge, there is only one formally published technique for skin protection in thyroid surgery.…”

Section: Surgical Technique Surgical Technique Surgical Technique Surmentioning

confidence: 99%

“…Therefore, it is essential to achieve the best cosmetic result in the classic open thyroidectomy scar, since the procedure is indicated for most patients. For this, several technical solutions have been proposed, such as prethyroid muscles section and thyroidectomy without detaching the skin flap 4 . Currently, conventional thyroidectomy is performed through an anterior necklace incision in the neck, two to three inches above the sternal notch, preferably on a natural neck fold or wrinkle, with a length ranging from four to six inches, depending on the anatomical characteristics of the patient (neck circumference) and the size of the gland to be removed 4 .…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

“…For this, several technical solutions have been proposed, such as prethyroid muscles section and thyroidectomy without detaching the skin flap 4 . Currently, conventional thyroidectomy is performed through an anterior necklace incision in the neck, two to three inches above the sternal notch, preferably on a natural neck fold or wrinkle, with a length ranging from four to six inches, depending on the anatomical characteristics of the patient (neck circumference) and the size of the gland to be removed 4 . In general, small incisions are more exposed to trauma by retractors or thermal injury by energy delivery devices, with a negative impact on the appearance of the resulting scar.…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

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Protecting the skin during thyroidectomy

Lira

Carvalho

Vartanian

et al. 2014

Rev. Col. Bras. Cir.

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In this note we describe the standard technical maneuver used in our department to protect the skin during thyroidectomy in order to get the best aesthetic result. We use surgical gloves to protect the skin during these operations to reduce the negative impact of thermal trauma and mechanical retractors and energy delivery devices at the edges of the skin incised. This practice is effective, inexpensive, rapid, reproducible and showed no complication in our experience of over 2,500 thyroidectomies.

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“…It must be extended to all structures dissected during the procedure [2]. Although there has been some work studying minimally invasive head and neck surgeries [3,4], our search revealed little literature available regarding minimally invasive techniques being applied to open surgical tracheostomy [5,6].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Elective Minimally Invasive with Conventional Surgical Tracheostomy in Adults

Sanji

Channegowda

Patil

2016

Indian J Otolaryngol Head Neck Surg

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Minimally invasive techniques were used for tracheostomy including small horizontal skin incision, limited soft tissue dissection and no suturing. A Retrospective analysis of case sheets of patients who underwent elective tracheostomy by the first and second authors at M S Ramaiah Hospitals in Bangalore between 1st May 2010 and 1st May 2015 was done to compare the result of elective conventional open surgical tracheostomy using midline vertical skin incision with minimally invasive tracheostomy using a short horizontal incision. No statistically significant difference in the peri and post operative complication rate was found. The patterns of intra and post operative complications reflected the choice of the surgical technique-the conventional technique had problems associated with wide dissection, whereas the minimally invasive technique had problems associated with limited exposure. Problems of wound gaping, emphysema and peristomal inflammation were reduced with minimally invasive technique with short horizontal skin incision although statistical difference could not be shown. There was also no statistically significant difference with either technique regards death and decannulation rates. Minimally invasive technique of elective open surgical tracheostomy was found to be as safe as conventional open surgical tracheostomy with midline vertical skin incision in the studied groups.

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Factors influencing the length of the incision and the operating time for total thyroidectomy

Cited by 14 publications

References 15 publications

Novel Thyroidectomy Difficulty Scale Correlates with Operative Times

Novel Thyroidectomy Difficulty Scale Correlates with Operative Times

Protecting the skin during thyroidectomy

Comparison of Elective Minimally Invasive with Conventional Surgical Tracheostomy in Adults

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