Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Lateral approach to thyroid(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Dissanayake, D.M.C.D.; Kumarasinghe, K.A.P.R.; Pinto, M.D.P.; Amaraweera, P.C.; Munasinghe, B.N.L.; Chandrasinghe, P.C.; Fernando, R.BACKGROUND: Thyroidectomy is the commonest endocrine surgical procedure, undertaken throughout the world. Re-do thyroidectomies are challenging procedures with a higher morbidity rate. Lateral approach to thyroid (LATT) is a good alternative to the standard midline exploration. The key to the technique is the development of the natural tissue plane between the strap muscle and the ipsilateral sternocledomastoid muscle to explore the thyroid bed. OBJECTIVE: This study was done to assess the efficacy, safety and complications of LATT. METHODS: Data on patients undergoing LATT in Professorial Surgical Unit, Colombo North Teaching Hospital, Ragama from 2008 to 2015 was collected prospectively and analyzed. All procedures were done by a single surgeon. RESULTS: A total 36 LATTs were done. Data from 32 people were collected as 4 patients were lost to follow up. 29 (90.6%) were females and 3 (9.4%) were males. Age ranged between 28 and 61 (Median 43.37) years. Three (9.4%) LATTs were for parathyroid explorations and out of which one (3.1%) was for redo parathyroid explorations. Nine (28.1%) were redo thyroidectomies and 18 (56.2%) were mini incision thyroidectomies with lateral approach. Hemi thyroidectomies were performed for 28 (87.5%). Bilateral explorations done for 3(9.4%) patients and 4(12.5%) lateral approaches done for completion thyroidectomies were for follicular malignant lesions. Transient clinical hypocalcaemia was noticed in 4 (12.5%) patients and 1 (3.1%) developed hoarseness of voice which was temporary. None of them had complications such as haematoma or post-surgery stridor. CONCLUSIONS: LATT is a safe alternative to the standard approach, for re-explorative thyroid surgery.Item Assessment of thyroid volume in adult Sri Lankans(Sri Lanka Medical Association, 2010) Fernando, R.; Bandara, D.M.S.M.; de Silva, A.; Renuka, M.D.OBJECTIVE: The ultrasound is the most sensitive method to detect goitre. Goitre size varies with different populations. Clinical palpation has low sensitivity. It is dependant on the experience of the examiner. Development of reference values for different populations is required. Objective of this study was to assess thyroid volume of Sri Lankans. METHODS: Patients taking inward treatment in the university surgicai unit for problems other than thyroid disorders and patients' bystanders were enrolled. Pregnant women, lactating women, acute or chronically ill patients, age below 16 years, abnormal echotexture or nodules on ultrasound examination were excluded. Subjects were selected randomly. Thyroid scan was done by a Consultant Radiologist. Thyroid volume was assessed using ellipsoid formula RESULTS: 60 males with mean age of 33 years were assessed. Their mean thyroid volume was 8.628 ml (2.73) with range of 2.657-15.15. Thirty females with median age of 42 were assessed. Mean thyroid volume of females was 6.413ml (1.66) with range of 2.871-9.737. This difference was statistically significant (p<0.01) Overall thyroid volume was 7.889ml (2.745). There was no significant difference in volume of both lobes (p>0.01). There was no significant correlation with height weight or BMI. Reference ranges for males and females were 8.628 ± 5.46 ml and 6.413 ± 3.32 ml respectively. CONCLUSION: Mean thyroid volumes of study sample of adult Sri Lankans were 8,628 ml (2.73) and 6.413ml (1.66) for males and females respectively. Reference ranges for males and females were 8.628 ± 5.46 mi and 6.413 ± 3.32 ml respectively.