ORCID Profile
0000-0002-4605-3816
Current Organisation
Sanjay Gandhi Post Graduate Institute of Medical Sciences
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Publisher: Archives of Endocrinology and Metabolism
Date: 24-08-2020
Publisher: Hindawi Limited
Date: 02-10-2018
DOI: 10.1155/2018/4057542
Abstract: Scarless (in the neck) endoscopic thyroidectomy (SET) has evolved into a cosmetically preferred alternative to conventional thyroidectomy (ConT). Recently many of our patients are demanding SET however their goitres are larger than the recommended size of 4–6 cm. Our aim was to compare the outcomes of ET for small ( cm) vs large (≥6 cm) goitres and determine its feasibility in such cases. This is a retrospective analysis of prospectively maintained database of patients undergoing ET. Patients were ided into 2 groups: I, small ( cm) and II, large goitres (≥6 cm). Their demographic and clinicopathological profiles, operation time, conversion and complication rates, and hospital stay were compared. 99 patients (101 procedures) were included: group I, 60 patients (61 procedures), and group II, 39 patients (40 procedures). Mean tumor size (± SD) was 4.4 ± 0.9 cm and 6.7 ± 1.1 cm in groups I and II, respectively. The groups were comparable with respect to demographic and clinical profile except for mean duration of goiter [30.1 ± 32.6 months (group I) vs 60.5 ± 102.4 months (group I), p = 0.03] and gland weight [21.5 ± 15.3 grams (group I) vs 62.3 ± 51.3 grams (group II), p = 0.001]. Although there was no significant difference between mean operating times, long term perioperative outcomes, and conversion rates, temporary hypocalcaemia and length of stay were longer in group II. One patient had permanent vocal cord palsy (~1%, 1/101) none had permanent hypoparathyroidism. Our results indicate that ET can be offered to a subset of patients with larger goitres desirous of SET with no significant difference in mean operation time, conversions, and long term postoperative complications in experienced hands.
Publisher: Springer Science and Business Media LLC
Date: 19-05-2020
Publisher: Hindawi Limited
Date: 2016
DOI: 10.1155/2016/9785849
Abstract: The aim of the current study was to investigate the efficacy of greater occipital nerve (GON) block and bilateral superficial cervical plexuses (BSCP) blocks in alleviating postoperative occipital headache and posterior neck pain after thyroidectomy. This randomized prospective study consisted of 75 women undergoing total thyroidectomy. Patients were randomized into three groups: Group I ( n = 25 ): patients receiving GON, Group II ( n = 25 ): patients receiving bilateral (BSCP) blocks, and Group III ( n = 25 ): patients receiving no block. Assessment of occipital headache, posterior neck, and incision site pains was made at 12 hours and 24 hours after extubation by Visual Analogue Scale (VAS). In comparison to Group III significantly fewer patients in Groups I and II experienced occipital headache at 12 ( p = 0.006 ) and 24 hours ( p = 0.005 ) and also posterior neck pain at 24 hours ( p = 0.003 ). Mean VAS scores at 12 and 24 hours for occipital headache ( p = 0.003 and p = 0.041 ) and posterior neck pain ( p = 0.015 and p = 0.008 ) were significantly lower in Group I. The differences between Groups II and III were not significant except for the occipital headache at 12 hours. The efficacy of GON block is superior to BSCP blocks in alleviating postthyroidectomy occipital headache and posterior cervical pain.
Publisher: Hindawi Limited
Date: 05-08-2018
DOI: 10.1155/2018/4910961
Abstract: Introduction . The concept of short stay thyroidectomy has been tested and in practice in the developed world the same has not been replicated in countries with limited resources due to lack of organized healthcare system. So, in this study, we tried to analyze if short stay thyroid surgery can be performed in a cost-effective way in developing countries and also if the endocrine surgical trainee can deliver these services safely. Methods . The study was conducted prospectively from January 2013 to July 2014, at Department of Endocrine Surgery, SGPGIMS, Lucknow, India. Study group included patients undergoing short stay hemithyroidectomy whereas matched patients who qualified for inclusion criteria but did not undergo short stay surgery due to various reasons constituted control group. Outcome in both the groups was compared in terms of complication rates, cost benefit, and patient satisfaction. Subgroup analysis was also done for trainee versus consultant performed short stay thyroid surgery. Results . A total of 439 patients with surgical thyroid disorders were evaluated at our institute during the study period and out of these 110 patients (58 cases and 52 controls) fulfilled the inclusion criteria. Younger patients with low socioeconomic status who were paying out of pocket were found to be more inclined to short stay thyroid surgery. There was no significant difference between the two groups in terms of postanesthetic discharge score (PADS), complication rates, and patients satisfaction however there was significant reduction (p .001) in hospital cost in short stay group. In subgroup analysis, procedure time was more in trainee performed surgeries however there was no significant difference in terms of mean PADS and complication rates. Conclusion . Short stay thyroidectomy can provide a better cost-effective alternative to conventional thyroidectomy in patients undergoing thyroid surgery and can be safely performed by endocrine surgical trainees even in a low resource setting.
Location: India
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