Inferior Thyroid Artery Ligation in Thyroid Surgery
Keywords:
Thyroidectomy, Thyroid Artery, Ligation, Thyroid SurgeryAbstract
Context: Thyroidectomy is a major as well as common surgery usually performed by endocrine or general surgeon. The postoperative complications, although rare in experienced hands, have severe implications on the patients.
Aim: - this study issued in Iraqi hospitals aimed to assess the effects and outcomes that result following ligation of the inferior thyroid artery during the procedure of thyroidectomy versus those which may follow thy roidectomy without ligation of this artery especially in the immediate postoperative period.
Patients & Methods: in this study 30 patients presented with goiter underwent different operations done by different surgeons from Jan. 2016 to Jan. 2017. The evaluation included the intraoperative maneuvers concerning ligation of the inferior thyroid artery during thyroidectomy whether ligation is done in continuity or by ligation-division or as temporary ligation & the effect and outcome of this step was studied in relation to the immediate postoperative complications in comparison to those without ligation of the inferior thyroid artery .
Results: the immediate postoperative complications and outcome following thyroidectomy with or without ligation of the inferior thyroid artery are relatively similar and show no significant difference.
Conclusion: the study results showed that no statistically significant difference was reported following thyroidectomy with ligation of the inferior thyroid artery versus those without ligation of this artery. Actually ligation of this artery has no effect on the outcome and subsequent postoperative complications.
References
Richard S. Snell Clinical Anatomy, 7th. ed. 2004.
Zygmunt H. Krukowski, (Thyroid gland) in Short practice of surgery 3th ed. (Arnold 2000).
Mohammed Kenawy, Alaa Mousa. (Endocrine surg.) In Kasr El Aini Introduction to surg. 3ed. ed. 2004.
Gregory P. Sadle, Orio H. Clark (thyroid & parathyroid) in principle of surg. by Seywour Schwartz, 7thed. New York 1999, 1661_1713.
Sabiston D.C. Text book of surg. (The Thyroid Gland) 15th ed.1997.
Safar SB. Al-Faris H.anatomical variations of RLN in thyroid sur. 1986.
Last RJ. Anatomy, 6thed.
Bowden REM.The surgical anatomy of RLN. Br. J. surg. 1955, 153-163.
John S.Kukora & James D. Hardy,( complications of thyroid & parathyroid surg.) in: complications in thyroid surg. and their management by James Hardy, 4th ed. WB. Sauder's 1981, 295.
Endocrine Disorders and Endocrine surg. update Jan. 2005.
Abdul Rahman Al Janabi: Carcinoma of thyroid gland. Iraqi Medical Journal 1979.
M. H. Layth (one year experience in thyroid surg.) in: Iraqi Army Med. Journal vol. 4, 1991.
M.A.R Al- Falluji (Historical background) in: William Heinemann medical books, Postgraduate of surg. 1986.
Johan Webb. "Endocrine surg. , Thyroid gland" in: Scott. An Aid to clinical surg. 6th. ed. by Rubin C. N. Williamson 1998.
R. F. Rintoul "Thyroid and parathyroid" in: Farquharson's Textbook of operative surg. 8th ed. 1995.
Mann B. SchaleP''Thyroid morphology and function after surg. Treatment if thyroid disease '' . Germany 1996 .
A.A. Abdel Rahim 'M.E. Ahmed & M.A Hassan.'' Respiraty complications after thyroidectomy and the need for tracheostomy patients with large goiter.''British journal of surg. 1999;86 .
Francois Patto& Frederic Combemale .''Hypocalcaemia following thyroid surgery , Incidence &Prediction of outcome world Journal of surgery 1998,22 .
Catz B.&PerzikS.''Total thyroidectomy in management of thyrotoxic&euthyroid Grave's Disease ''AMJ.surgery 1989,118:434 .
Klamar F.,Bancer .''Standerized morphology adjusted resection in treatment of benign nodular struma''.
AraujoFilhoVJ , Silva F.G.B. ''Importance of ligation of inferior thyroid artery in parathyroid function after subtotal thyroidectomy ''.July-Aug. 2000-55(4) .
Dolapci M. , Kama NA. ''Truncal ligation of inferior thyroid artery does not affect the incidence of hypocalcaemia after thyroidectomy ''. Study on 216 pations-turkey (90-1991)surgery 2000 Apr. ,116 .
Therman M. &Feltramp M.''RLN paralysis after thyroid operations, Etiology & consequences ''. Chirup Sep. 1998;69(9) .
WbeelerMacolm .''Thyroid surgery & RLN ''.British Journal of surgery .1999;86 .
BarnoutiN.H.''Iraqi Pattern of goiter ''.Iraqi Army Medical Journal vol. 7. 1995 .
Lu J. ,Ebrahim NA, N adim Y .''Anerior Approach to cervical spine ''2000 Aug .
W. Lamade ,KRenz, ''Effect of training on RLN injury ''. British Journal of surgery 1999;86 .
ThomuschO., Sekulla C. '' Impact of surgical technique on post operative hypothyroidism in bilateral thyroid surgery.'' National Library of Medicine . Surg.2003 Feb.,133 .
Al-Fakhry N. ,Runkel N. , Buhr H. ''Rate of complications with systemtic exposure of the RLN and parathyroid in the operation for benign thyroid disease . ZentralblChir1998 ; 123 (1) .
Friedric T, SteinertM,Keitel R. ''Incidence of damage to RLN in surgical therapy of various thyroid gland disease .Respective study .Zentralblchir 1998;123(1) .
Ahmed Jarrallah , ''RLN injury after thyroid gland surgery ' in Baghdad teaching hospital .1998 .
Abdul Ameer Al-Darraji . "Morbidity of thyroid surgery '' In Al-Rasheed Hospital. 1998.