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Lateral backdoor approach versus conventional anterior approach in recurrent Thyroid surgery


Mohamed El-kordy , Sameh Gabr Attia , Hesham Wefky Anwar , Ibrahim Aboulfotoh Mohamed , Eid Rezk Elgamal , Mohamed Ibrahim Shalamesh and et al

Abstract

Background: Recurrent thyroid surgery has a greater risk of complications due to excessive fibroses and increased tissue fragility from the preceding operation. Numerous surgical practices and approaches have been endorsed to reduce the complications accompanied with recurrent thyroid surgery. Objective: A combined prospective and retrospective study to assess the complication rate of individuals undergoing a thyroid surgery for the second time by applying a lateral backdoor methodology in comparison with a primary intervention. Patients and Methods: The results of 50 subjects underwent recurrent thyroid operation for benign or malignant thyroid disease (Groups I and Group II) were compared. The operations were done by means of a classical midline and lateral method. Admission was attained amongst the anterior border of the strap muscles and the sternocleidomastoid muscle. In 1ry operation, the thyroid was entered. Results: The average age of group I was 49.9±14.1 years, while in group II, it was 45±12.6 years, and ranged from 22-65 years; p=0.69. In the present study 90.9% (n=43) of the population in group I were females, while in group II it reached 75% (n=33), p=0.87. 25% of patients in group I and 7 (15.9%) of patients in group II were subjected to surgical interference owing to the occurrence of a malignancy (p=0.29). Bilateral interference was performed in 26 (59.1%) individuals in Group I, whereas, in Group II it reached 28 (63.6%) subjects. Conclusion: The lateral backdoor approach is a safe less traumatizing technical approach help to control the superior thyroid vascular pedicle and avoid aggressive rough handling of strap muscles by both cutting or excessive retraction and vigorous gland manipulation.



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