In this case report we present a rare case of thymoma in middle midiastinum of a 48 years woman presented by dyspnea and massive plural effusion.

Background:Thyroidectomy is one of the most common forms of operations in general surgery. Regarding the status and importance of thyroidectomy and protective measures for avoiding the surgical complications, we aimed at investigating the short-term postoperative complications of thyroidectomy by applying the two methods of ligature use and suture ligation of vessels.Settings:Department of Surgery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.Materials and Methods:This Double-blind randomized clinical trial study conducted on 140 candidates of thyroidectomy. The patients were randomlyequally allocated assigned to two groups of 70. In the ligature group, thyroidectomy was performed via ligature use, and in the suture ligation group, it was done with suture ligature. Using a specific questionnaire, the required demographic information, type of surgical operation, duration of surgery, rate of bleeding, the preoperative and postoperative serum calcium concentration, hypocalcemia symptoms, hoarseness, and laryngoscopic findings were collected and analyzed.Results:The findings revealed that the average time of total and subtotal thyroidectomy lasted 93.94 ± 10.53 min with ligature use and 134.15 ± 13.57 min with suture ligation. No case of postoperative bleeding was observed in this study. Two patients (17.1%) in the suture ligation group and two patients in the ligature group showed signs of hypocalcemia. Six patients developed hoarseness of whom five belonged to the ligature group and one belonged to the suture ligation group.Conclusions:Regarding the fact that on the whole, duration of thyroidectomy was shorter in ligature approach compared to the suture ligation, it can be considered as a suitable method to substitute suture ligation. However, meticulous precautions should be taken specifically with regard to the efferent laryngeal nerve and hoarseness.