Modified thyroidectomy: 4 techniques to prevent recurrent laryngeal nerve injury and postoperative hypocalcaemia

Objective:To share 4 techniques that decrease the rate of postoperative hypocalcaemia and save recurrent laryngeal nerve with a good cosmetic outcome.Method:The research included all consecutive patients of thyroidectomy (hemi and total thyroidectomy) during 4-year practice. The techniques included (1) elevation of a circular flap after 4 cm collar incision.(2) Ligation of the pedicles (middle first-vein, inferior last-artery).(3) Sharp dissection of the parathyroid glands.(4) Sharp and blunt dissection and exposing the nerve in all of the patients.Result:The total numbers of patients were 2399. At least 1 symptom of hyperthyroidism was found in 1271 patients (53%).

The main indication for operation was multinodular goiter and compression symptoms in 1331 (55.5%) patients, followed by thyrotoxicosis in 598 (25%) patients and malignancy in 402 (16.8%) patients. The most common operations were total …