An interventional study of Microscopic Thyroidectomy and Conventional Thyroidectomy in Thyroid Cancer and Thyroid Surgeries, sponsored by Shahida Islam Medical Complex. Completed at 1 site in Pakistan. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-03-23.
Sponsored by Shahida Islam Medical Complex · Not applicable, Interventional, and Treatment
Despite promising findings from international studies, the use of microscopic thyroidectomy remains limited in local surgical practice, where conventional thyroidectomy is traditionally followed. There is a scarcity of local data evaluating the benefits of MT, and inconsistencies in reported outcomes highlight the need for further research. The lack of standardized protocols and limited surgeon experience with microscopic techniques contribute to hesitation in its adoption.
This study aims to address the research gap by providing comparative data on operative time, intraoperative blood loss, and postoperative complications in microscopic versus conventional thyroidectomy in our setting. The findings will aid in determining whether MT should be incorporated into routine surgical practice to improve patient outcomes and reduce postoperative complications.
Thyroid disorders requiring surgical intervention are common, with conditions such as multi nodular goiter, thyroid malignancies, and hyperthyroidism frequently necessitating thyroidectomy. The procedure, while effective, poses risks due to the intricate anatomy of the thyroid gland and its proximity to critical structures such as the recurrent laryngeal nerve (RLN), external branch of the superior laryngeal nerve (EBSLN), and parathyroid glands. Complications like RLN palsy, hypocalcemia, and hematoma can result in significant morbidity. Hypocalcemia occurs in 20%-30% of cases, while RLN injury is reported in 5%-11%, with bilateral RLN paralysis being a rare but life-threatening complication. Minimizing these risks requires precise surgical techniques, adequate anatomical knowledge, and surgeon expertise. Thyroid surgery has evolved significantly, incorporating various approaches to enhance safety and outcomes. Conventional thyroidectomy (CT) remains the standard procedure, providing direct visualization and effective gland excision. Endoscopic thyroidectomy, utilizing minimal access techniques, has improved cosmetic outcomes but often involves longer operative times. The use of robotic-assisted thyroidectomy has further advanced precision, though cost and availability remain limiting factors. Microscopic thyroidectomy (MT), which involves magnification techniques for enhanced visualization, has been introduced to minimize complications. Studies suggest MT offers superior preservation of RLN, EBSLN, and parathyroid glands, reducing transient nerve palsies and hypocalcemia rates compared to conventional approaches.
However, it is essential to assess its efficacy in routine clinical practice.
785 studies on the registry are indexed under Thyroid Neoplasms; 204 are open to participants now.
This study's enrollment of 74 is above the median of 53 across 520 interventional studies indexed under Thyroid Neoplasms.
Browse Thyroid Neoplasms studies →Shahida Islam Medical Complex is the lead sponsor of 8 studies on the registry; none are open to participants now.
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Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Hemodynamically stable patients without significant comorbidities affecting surgery or anesthesia based on (Class I-III).
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.
A blood test of average blood sugar over the past two to three months, given as a percentage or in mmol/mol. 6.5% (48 mmol/mol) or more is the usual threshold for diabetes, normally confirmed by a second test.
GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².
Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.
A score of how well the liver works in people with liver disease such as cirrhosis: class A is mild, B moderate and C severe.
Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.
Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.
Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.
ASA physical status
The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Metastases
Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
HbA1c
A blood test of average blood sugar over the past two to three months, given as a percentage or in mmol/mol. 6.5% (48 mmol/mol) or more is the usual threshold for diabetes, normally confirmed by a second test.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
GFR and eGFR (kidney filtering)
GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².
Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Child-Pugh class
A score of how well the liver works in people with liver disease such as cirrhosis: class A is mild, B moderate and C severe.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
INR, PT and aPTT (clotting tests)
Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.
Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Platelets
Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Procedure: Microscopic Thyroidectomy
Procedure: Conventional Thyroidectomy
The procedure was done under general anesthesia but with an endotracheal intubation. Transverse cervical incision (45 cm) was done along a natural skin line. Magnification (Zeiss Sensera, 3-5x magnification) was employed in order to make the recurrent laryngeal nerve (RLN), external branch of the superior laryngeal nerve (EBSLN), and parathyroid glands easier to dissect. The ligatures were done at the superior pole of the thyroid gland and not at EBSLN. The RN was determined on the entry site to the larynx and kept in perfect condition. The parathyroid glands were distinguished, frozen or remedied in the event of the devascularization. The thyroid gland had been removed according to the intended operation (lobectomy, sub-total, or the total thyroidectomy). The wound was closed in layers and hemodynamics was restored
A similar method was employed except that no microscopic magnification was employed. The standard visual techniques were used to identify RN and EBSLN and the process was accomplished according to the traditional approach. The traditional methods were used to identify and preserve parathyroid glands without any further magnification. The recovery room paid close attention to patients following surgery in case of any immediate complications such as bleeding or airway obstruction. Serum calcium levels were tested 24 hours after operation to determine whether they were hypocalcaemic and indirect laryngoscopy carried out prior to discharge to determine the functioning of the vocal cords
Mean intraoperative blood loss
It will be defined as the mean total volume of blood lost during the surgical procedure, measured in milliliters (mL). Blood loss will be estimated using the difference between preoperative and postoperative suction canister volumes, accounting for irrigation fluids, and by weighing surgical sponges and gauze (1 g of blood = 1 mL).
Time frame: 0 days
Percentage of Transient Recurrent Laryngeal Nerve (RLN) Palsy
postoperative unilateral or bilateral impairment of vocal cord mobility due to RLN dysfunction, confirmed by indirect laryngoscopy or videolaryngostroboscopy performed by an otolaryngologist. Diagnosis will be based on reduced or absent vocal cord movement compared to preoperative assessment. Patients exhibiting hoarseness, breathiness, or dysphonia with confirmed vocal cord dysfunction on laryngoscopic evaluation within one month postoperatively will be labeled as transient RLN palsy. Any patient showing full recovery of vocal cord mobility on follow-up laryngoscopy at one month will be classified as transient.
Time frame: one month
Percentage of Permanent Recurrent Laryngeal Nerve (RLN) Palsy
persistent postoperative unilateral or bilateral vocal cord paralysis confirmed by indirect laryngoscopy or videolaryngostroboscopy at one month postoperatively by an otolaryngologist. Diagnosis will require complete absence of vocal cord movement on objective examination at one month, without any signs of recovery. Patients with persistent hoarseness, dysphonia, or aspiration symptoms accompanied by vocal cord immobility at one month will be definitively classified as having permanent RLN palsy.
Time frame: one month
percentage of Transient Hypocalcemia
It will be labeled as transient hypocalcemia if the patient experiences symptoms such as perioral numbness, carpopedal spasms, or tetany within one month of surgery, with laboratory confirmation of serum calcium \< 8.0 mg/dL. Diagnosis will be based on serial calcium measurements, and resolution within one month without continued supplementation will confirm its transient nature.
Time frame: one month
Plan to share: No
No publications or documents are linked to this record.
Ran from Dec 2025 to primary completion in Mar 2026, 2 months.
Of 126 non-industry interventional studies with no phase under Thyroid Neoplasms, half reached primary completion within 46 months of starting (the median), counting those still running; a quarter within 14 and three quarters within 78. This study's 2 months is below that.
Counting every sponsor, half of 127 studies reached it within 46 months; a quarter within 14 and three quarters within 78.
How these figures are worked out, and which studies are left out of them.
This study is completed, as verified in Mar 2026. You cannot join it, but the record below documents what was studied.
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Shahida Islam Medical Complex