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Outpatient thyroidectomy

Irene Lou, Todd B Chennell, Sarah C Schaefer, Herbert Chen, Rebecca S Sippel, Courtney Balentine, David F Schneider, Jacob Moalem
BACKGROUND: Thyroidectomy and parathyroidectomy are the most commonly performed endocrine operations, and are increasingly being completed on a same-day basis; however, few data exist regarding the outpatient postoperative pain requirement of these patients. We aimed to describe the outpatient narcotic medication needs for patients undergoing thyroid and parathyroid surgery, and to identify predictors of higher requirement. METHOD: We examined patients undergoing thyroid and parathyroid surgery at two large academic institutions from 1 January-30 May 2014...
February 3, 2017: Annals of Surgical Oncology
Lisa Caulley, Stephanie Johnson-Obaseki, Lindy Luo, Hedyeh Javidnia
Thyroid cancer incidence is increasing, and with it, an increase in total thyroidectomy. There are limited studies comparing outcomes in total thyroidectomy performed in the inpatient versus outpatient setting.The objective of this study was to perform a comparative analysis of risk factors and outcomes of postoperative morbidity and mortality in total thyroidectomy performed as an inpatient versus outpatient surgery.Retrospective cohort study of data from the 2005 to 2014 multi-institutional, risk-adjusted American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database...
February 2017: Medicine (Baltimore)
Maria Regina Marrocos Machado, Marcos Roberto Tavares, Carlos Alberto Buchpiguel, Maria Cristina Chammas
Objective To determine what ultrasonographic features can identify metastatic cervical lymph nodes, both preoperatively and in recurrences after complete thyroidectomy. Study Design Prospective. Setting Outpatient clinic, Department of Head and Neck Surgery, School of Medicine, University of São Paulo, Brazil. Subjects and Methods A total of 1976 lymph nodes were evaluated in 118 patients submitted to total thyroidectomy with or without cervical lymph node dissection. All the patients were examined by cervical ultrasonography, preoperatively and/or postoperatively...
February 2017: Otolaryngology—Head and Neck Surgery
Hirotoshi Nakamura, Akane Ide, Takumi Kudo, Eijun Nishihara, Mitsuru Ito, Akira Miyauchi
OBJECTIVE: Finding agranulocytosis (AG) at an early stage is important to improve outcome, but periodic granulocyte count monitoring is not generally recommended for patients with Graves' disease, because AG develops suddenly. METHOD: At the Kuma Hospital, Graves' patients under antithyroid drug (ATD) treatment in an outpatient clinic have a granulocyte count examination during each visit, and if it is <1,000/μl, a warning is immediately sent to the patient's physician...
December 2016: European Thyroid Journal
Kristin Long, Joseph Ruiz, Spencer Kee, Alicia Kowalski, Farzin Goravanchi, Jeff Cerny, Katy French, Mike Hernandez, Nancy Perrier, Elizabeth Rebello
STUDY OBJECTIVE: Two of the most feared complications for patients undergoing thyroid surgery are pain and postoperative nausea and vomiting. Thyroidectomy is considered high risk for postoperative nausea and vomiting, and recent studies have looked at adjuncts to treat pain, limit narcotic use, "fast-track" the surgical process, and enhance recovery without compromising the patient's safety. One such perioperative medication of interest is dexmedetomidine (Dex), a centrally acting α-2 agonist that has been associated with reducing pain and postoperative opioid consumption...
December 2016: Journal of Clinical Anesthesia
Jun-Ook Park, Ja-Sung Bae, So-Hee Lee, Mi-Ran Shim, Yeon-Shin Hwang, Young-Hoon Joo, Young Hak Park, Dong-Il Sun
OBJECTIVES: Thyroid surgeons frequently encounter outpatients with mobile vocal cords complaining of lower-pitched voices following thyroidectomy. This study investigated the clinical and pathological parameters affecting voice pitch following thyroid surgery. METHODS: We analyzed the data of 393 patients with mobile vocal cords and who also underwent thyroid surgery. Speaking fundamental frequency (SFF) and fundamental frequency (F0) were compared before and after surgery...
February 2017: Annals of Otology, Rhinology, and Laryngology
D G Zhang, L Gao, L Xie, G F He, L Fang, J Chen, Y W Miao, Z Z Wang
Objective: To discuss the feasibility, safety and oncologic completeness of modified minimally invasive video-assisted lateral neck dissection (MIVALND) for papillary thyroid carcinoma. Methods: Data of 130 patients from Department of Head and Neck Surgery, Sir Run Run Shaw Hospital, Medical School, Zhejiang University undergoing MIVALND from January 2013 to September 2015 were reviewed retrospectively. There were 31 male and 99 female patients with the mean age of (39±11) years. The thyroidectomy and central compartment dissection were performed under a direct visual field or video-assisted (VA) approach, lateral neck dissection was performed via the VA approach...
November 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
William S Duke, F Christopher Holsinger, Emad Kandil, Jeremy D Richmon, Michael C Singer, David J Terris
BACKGROUND: Robotic facelift thyroidectomy (RFT) was developed as a new surgical approach to the thyroid gland using a remote incision site. Early favorable results led to this confirmatory multi-institutional experience. METHODS: Prospectively collected data on consecutive patients undergoing RFT in five North American academic endocrine surgical practices were compiled. Surgical indications, operative times, final pathology, nodule size, complications, and postoperative management (drain use and length of hospital stay) were evaluated...
January 2017: World Journal of Surgery
Shigeki Minami, Keiji Inoue, Junji Irie, Takashi Mine, Nobuhiro Tada, Masataka Hirabaru, Kazumasa Noda, Shinichiro Ito, Masashi Haraguchi
The incidence of thyroid metastasis among colorectal cancer patients is extremely rare. We report a case of colonic adenocarcinoma metastasis to the thyroid gland with treatment of lung and liver metastases, in a 61-year-old woman with a history of colon cancer. She showed a thyroid mass related to a 3-month history of hoarseness. Physical and imaging examinations disclosed a diffuse large thyroid mass with swollen cervical lymph nodes. Fine-needle aspiration cytology of the thyroid mass suggested malignancy...
December 2016: Surgical Case Reports
Alexandra E Quimby, Simon T Wells, Matthew Hearn, Hedyeh Javidnia, Stephanie Johnson-Obaseki
OBJECTIVE: The purpose of this study was to perform a systematic review and meta-analysis to determine whether a difference exists in hematoma rates following thyroidectomy for any of the following subgroups of patients: Graves disease, toxic nodular goiter (TNG), and malignancy. STUDY DESIGN: Systematic review and meta-analysis. METHODS: A systematic literature search was performed for all relevant English and French language studies (1946-2015) using Ovid MEDLINE, EMBASE, and PubMed...
August 2, 2016: Laryngoscope
Charles Meltzer, Marc Klau, Deepak Gurushanthaiah, Joanne Tsai, Di Meng, Linda Radler, Alvina Sundang
OBJECTIVES/HYPOTHESIS: To test our hypothesis that high-surgeon volume is associated with improved surgical efficiency and 30-day outcomes, and lower hospital utilization. STUDY DESIGN: Retrospective observational cohort, 2008-2013. METHODS: A total of 3,135 patients with hemithyroidectomy or total thyroidectomy performed by a high-volume surgeon, propensity score-matched to 3,135 patients with the same procedure performed by a low-volume surgeon...
June 23, 2016: Laryngoscope
Russell B Smith, Andrew Coughlin
Total thyroidectomy has significantly changed over the years from a morbid procedure to one that is performed routinely on an outpatient basis. This article reviews the history of thyroid surgery with regard to hemostasis, discusses surgical vascular anatomy, and describes the methods of hemostasis. It compares traditional hemostatic surgical techniques with newer techniques such as the Harmonic Scalpel and LigaSure hand pieces. The use of adjunctive hemostatic agents and indications for a drain in thyroid are discussed...
June 2016: Otolaryngologic Clinics of North America
Zaid Al-Qurayshi, Gregory W Randolph, Sudesh Srivastav, Rizwan Aslam, Paul Friedlander, Emad Kandil
OBJECTIVES/HYPOTHESIS: Disparities in economic and social parameters have been identified as underlying factors that influence diseases outcomes. We aim to examine the influence of community-specific measures on outcomes related to thyroid surgery. STUDY DESIGN: A cross-sectional study utilizing the State Inpatient databases and State Ambulatory Surgery and Services databases, 2010 to 2011. Those databases were merged with the County Health Ranking database. METHODS: The study population included adult (≥18 years) inpatients and outpatients who underwent thyroidectomy...
September 2016: Laryngoscope
Z Al-Qurayshi, S Srivastav, E Kandil
BACKGROUND: Thyroidectomy is increasingly being performed as an outpatient procedure. In this study, we aim to examine patient characteristics and clinical factors associated with outpatient thyroid surgeries as compared to inpatient procedures. METHODS: A cross-sectional study for the period of 2007-2010. Inpatients and outpatients were selected from the Nationwide Inpatient Sample and State Ambulatory Surgery and Services Databases, respectively. All patients were adults (≥18 years) who underwent thyroidectomy in the States of Florida and New York...
July 2016: European Journal of Surgical Oncology
Charles Meltzer, Marc Klau, Deepak Gurushanthaiah, Joanne Tsai, Di Meng, Linda Radler, Alvina Sundang
OBJECTIVE: To test our hypothesis that general and thyroid surgery-specific complications, mortality, and postdischarge utilization for patients undergoing outpatient and inpatient thyroid and parathyroid surgery would not differ when outpatient status was defined as discharge within 8 hours of surgery completion. STUDY DESIGN: Retrospective observational cohort, 2008 to 2013. SETTING: Kaiser Permanente Northern California and Kaiser Permanente Southern California...
May 2016: Otolaryngology—Head and Neck Surgery
Kohei Nishimoto, Yoshihiko Kumai, Daizo Murakami, Eiji Yumoto
We report a rare case of black thyroid accompanied by papillary carcinoma in a patient with an extended history of minocycline treatment. A 78-year-old man was referred to our outpatient clinic with swelling in his neck. He had been taking minocycline for the previous 2 years and 7 months to treat chronic perianal pyoderma. Neck ultrasonography and computed tomography demonstrated a 3.5 × 3.7 × 5.0-cm nodule in the left thyroid lobe, and fine-needle aspiration cytology identified it as a papillary carcinoma...
March 2016: Ear, Nose, & Throat Journal
Kurt L Nelson, Andrew M Hinson, Bradley R Lawson, Derek Middleton, Donald L Bodenner, Brendan C Stack
OBJECTIVE: To describe a safe and effective postoperative prophylactic calcium regimen for same-day discharge thyroid and parathyroid surgery. STUDY DESIGN: Case series with chart review. SETTING: Tertiary referral academic institution. SUBJECTS AND METHODS: In total, 162 adult patients who underwent total thyroidectomy, completion thyroidectomy, unilateral parathyroidectomy, parathyroidectomy with bilateral neck exploration, or revision parathyroidectomy were identified preoperatively to be candidates for same-day discharge...
May 2016: Otolaryngology—Head and Neck Surgery
Andrew Brekke, Dawn M Elfenbein, Tariq Madkhali, Sarah C Schaefer, Cindy Shumway, Herbert Chen, David F Schneider, Rebecca S Sippel, Courtney Balentine
BACKGROUND: Little is known about care coordination and communication with outpatient endocrine surgery patients. This study evaluated phone calls between office nurses and surgical patients to identify common issues addressed and their effect on patient care. METHODS: Qualitative analysis of preoperative and postoperative phone conversations between office nurses and endocrine surgery patients. RESULTS: We identified 183 thyroidectomy patients with 38% contacting our office before surgery and 54% within 30 days after surgery...
March 2016: American Journal of Surgery
Courtney J Balentine, Rebecca S Sippel
Outpatient thyroid surgery is controversial because of concerns over life-threatening cervical hematoma. Despite this concern, outpatient thyroidectomy is becoming increasingly common, especially among high-volume endocrine surgeons. Multiple studies have now demonstrated that careful patient selection combined with surgeon experience can result in successful and safe surgery without a full inpatient admission. This article reviews the data on safety and outcomes for outpatient thyroidectomy and discusses several techniques used to minimize risk to patients...
January 2016: Surgical Oncology Clinics of North America
Jamie M Segel, William S Duke, Jennifer R White, Jennifer L Waller, David J Terris
OBJECTIVES: Outpatient thyroid surgery is becoming increasingly common. The aim of this study was to clarify the principles for safe outpatient thyroid surgery and review our outcomes with the use of a protocol for outpatient thyroidectomy in a large patient cohort. STUDY DESIGN: A systematic analysis of a prospectively maintained database of outcomes of thyroidectomy in a tertiary endocrine surgery practice. SETTING: Academic medical center...
February 2016: Surgery
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