Gowrishanmugan, N (2020) Prospective study on Intraoperative Methylene Blue Spraying over Operative Field of Thyroid Surgery in Preserving Parathyroid Gland. Masters thesis, Madurai Medical College, Madurai.
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Abstract
INTRODUCTION: Most commonly performing surgery in endocrine disorder is thyroid surgery. The Outcome of thyroid surgery depends upon the relieving the endocrinopathy and to reduce the postoperative surgical complication. In India, Around 41 million of people suffered from thyroidal disorders and benign condition are most in numbers Thyroidectomy done for thyrotoxicosis, benign and malignant tumours of thyroid, relieve the pressure effect due to thyroid enlargement, cosmetic purpose, failure to medical treatment. Type of thyroidectomy are hemi thyroidectomy, subtotal thyroidectomy, near total thyroidectomy, total thyroidectomy, isthmusectomy. Initially subtotal or near total thyroidectomy was done for benign conditions like MNG, these procedures were comparatively safer with respect to total thyroidectomy. OBJECTIVES: Aimed to evaluate the effectiveness of intra operative methylene blue stain spraying in identifying the parathyroid gland & minimize the postoperative complication in thyroid surgery. MATERIAL AND METHODS: This prospective study was conducted who were planned for total thyroidectomy in Madurai Rajaji College and hospital around 50 patients. In which 25 patient were stained with methylene blue dye intra operatively and other 25 patients were not stained with methylene dye. Before the inferior pole ligation, 0.5 ml (1:10 dilution) methylene sprayed over the thyroid lobe and perilobar area. The parathyroid glands, recurrent laryngeal nerve, inferior thyroid artery were looked for identification and preservation RESULTS: Recurrent laryngeal nerve won’t get stain while thyroid and parathyroid tissue got stained in blue colour. Parathyroid glands had wash out the blue stain and regain their original yellow colour within three minutes due to their rich lympho vascular structure. Wash out time for thyroid tissue took more than 15 minutes. Recurrent laryngeal nerve won’t stained and remains in white at all times due to Schwann sheath. With the methylene blue staining, parathyroid were identified in all the 25 patients. Without methylene blue staining, parathyroid not identified in 6 out of 25 patients in that group. So parathyroid identification were better with methylene blue staining & significant p value <0.05 CONCLUSION: Spraying of methylene blue dye during thyroid surgery to identify the parathyroid is a safe and effective technique and avoiding injury to parathyroid and RLN.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 221711105 |
| Uncontrolled Keywords: | Intraoperative Methylene Blue Spraying, Operative Field, Thyroid Surgery, Preserving Parathyroid Gland. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 10 Feb 2021 01:10 |
| Last Modified: | 10 Feb 2021 01:12 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13964 |
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