Content area
Full text
(ProQuest: ... denotes non-US-ASCII text omitted.)
Main Articles
Introduction
Thyroidectomy is one of the most frequently performed procedures in general surgery. The cornerstone of safe and effective thyroid surgery is a thorough understanding of the thyroid anatomy.1Guillaume Dupuytren performed the first well-documented anatomical total thyroidectomy in 1808, and described dividing all four arteries and removing the goitre through sharp dissection.2However, truly safe and effective thyroid surgery came of age with Kocher and Halsted, who developed a standardised technique for thyroidectomy (i.e. dissection within the thyroid capsule).3
In the past century, the study of thyroid anatomy has focused on the recurrent laryngeal nerve (RLN), non-recurrent laryngeal nerve, external branch of the superior laryngeal nerve, parathyroids, tubercle of Zuckerkandl, and sympathetic to laryngeal nerve anastomosis, and has centred around safety. In addition, the importance of the thyroglossal tract and pyramidal remnants, thyrothymic thyroid rests, and anatomical variations of the thyroid has been discussed with respect to the completeness of surgery.2
However, the false thyroid capsule (also known as the surgical capsule or perithyroid sheath) has only rarely been described. It is a thin layer of fascia enveloping the thyroid gland, which needs to be dissected away from the thyroid during surgery.4Most anatomists and surgeons have described it as a thin capsule deriving from the pretracheal fascia.1,2,4,5The false thyroid capsule plays an important role in capsular dissection, as described by Gemsenjaeger.4
In the current study, we explored the anatomy of the false thyroid capsule during thyroid lobectomy, in order to further define its clinical significance.
Patients and methods
Patients
The study included 151 patients with goitre who underwent thyroid lobectomy in the department of thyroid and breast surgery of the affiliated Nanhai Hospital of Southern Medical University, Foshan, between April 2011 and February 2012. There were 124 women and 27 men, with a mean age of 38 years (range, 19-75 years). The patients' mean body mass index was 24.3 kg/m2(range, 21.7-28.2 kg/m2).
Patients with a history of previous neck surgery or radiation exposure were excluded from the study.
All patients signed an informed consent form prior to study enrolment.
Patients were thoroughly evaluated via physical examination, thyroid...