The Effect of Table-Attachable and Adjustable Retractor System on Pain After Thyroidectomy

thyroid

Thyroidectomy can be performed by conventional open surgery, endoscopic or robotic methods. Although endoscopic or robotic surgery may be performed for more favorable cosmetic outcomes and improved postoperative patient satisfaction, conventional open surgery is still the most preferred method. In an operation performed via Kocher incision, the adequate retraction of surgical field to have acceptable angle of view, is the key because of the small size of the field and close proximity to the vital vascular and neuronal structures of the thyroid gland. Although there is no standard tool for the retraction of surgical field, the operation can be performed with various retractors such as a retractor requiring an additional person or self-retaining retractors which may provide stable retraction without additional person. In this study, we aimed to evaluate the outcomes of the self-retaining retractor on clinical outcomes in patients undergoing thyroidectomy.

The patients who underwent thyroidectomy between May 2016 and February 2018 in the Department of General Surgery, Karadeniz Technical University, were included in the study retrospectively. In order to reduce the bias resulting from the technical and practical differences among surgeons, thyroidectomy performed by only two surgeons were evaluated. Patients were divided into two groups as conventional method group which the self-retaining retractor was not used versus the group which is table-attachable/adjustable self-retaining retractor developed by Professor Akif CİNEL, MD was used. Preoperative, intraoperative and postoperative data were collected for both groups.

Findings: There were no statistically significant differences between the two groups for the pain scores that were measured at the 4th, 12th, 24th and 48th hour postoperatively. Additional analgesia was required in 29 patients (27.6%) for the conventional group and in 17 patients (15.9%) for the self-retaining retractor group and there was a statistically significant difference between the two groups (p:0.038).

Table-attachable/adjustable self-retaining retractor which does not require an additional person during surgery, provides similar results in terms of operation time, amount of intraoperative bleeding and postoperative complications as compared to conventional method. It also provides less additional analgesia requirement for pain which is an important factor for postoperative patient satisfaction. Table-attachable/adjustable self-retaining retractor can be used as a safe and effective tool during open thyroidectomy.

Keywords: Thyroidectomy, Retractor, Postoperative Pain, Self-Retaining

-This study is made by Reyyan Yıldırım

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