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Same day thyroidectomy

M S Farooq, R Nouraei, H Kaddour, M Saharay
INTRODUCTION Post-thyroidectomy bleeding is a low frequency but potentially life threatening event that is very difficult to predict. Given the increasing drive towards thyroidectomy with same day discharge, this study was conducted with the aim of identifying patterns, timing and consequences of post-thyroidectomy bleeding to assess the feasibility of day-case thyroidectomy. METHODS All patients who underwent a thyroidectomy between 2008 and 2015 at our institution were identified. Patterns, timing and consequences in all those who developed post-thyroidectomy bleeding were studied...
August 23, 2016: Annals of the Royal College of Surgeons of England
Ashwini C Reddy, Gyan Chand, M Sabaretnam, Anjali Mishra, Gaurav Agarwal, Amit Agarwal, A K Verma, S K Mishra
BACKGROUND: Hypocalcaemia following total thyroidectomy is a major contributing factor in delayed hospital discharge and dissuading surgeons from day care thyroidectomy. We prospectively evaluated the utility of Intra-operative serum quick parathyroid hormone level measurement twenty minutes after total thyroidectomy in predicting post-operative hypocalcemia. MATERIAL AND METHODS: Prospective longitudinal study which included patients undergoing total thyroidectomy for benign or malignant thyroid disorders at SGPGIMS, Lucknow, India from November 2013 to February 2015...
August 12, 2016: International Journal of Surgery
Geun Joo Choi, Hyun Kang, Eun Jin Ahn, Jong In Oh, Chong Wha Baek, Yong Hun Jung, Jin Yun Kim
BACKGROUND: Systemic lidocaine has analgesic and anti-inflammatory effects. The purpose of this prospective, randomized, double-blind study was to evaluate the effects of intravenous lidocaine on pain following thyroidectomy. METHODS: Fifty-eight adult patients scheduled for total thyroidectomy were randomly allocated to receive a 1.5 mg/kg lidocaine bolus followed by a 2 mg/kg/h infusion during surgery, or the same volume of normal saline (control). After thyroidectomy, we evaluated postoperative pain, nausea, fentanyl consumption, frequency of pushing the button (FPB) for patient-controlled analgesia (PCA), High-sensitivity C-reactive protein (hs-CRP) in serum, and patient satisfaction scores regarding the recovery process...
July 5, 2016: World Journal of Surgery
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
Ki Hwan Hong, Woo Seok Yang, Min Ju Park, Jong Seok Oh, Baek Hwa Han
Objectives: Voice and speech alterations after total thyroidectomy may be associated with other extralaryngeal factors, such as neck muscle dysfunction and neck scar contracture. We evaluated the acoustic characteristics of oral vowel sounds and changes in hyoid bone movement before and after thyroidectomy. Methods: Twenty-nine female patients undergoing total thyroidectomy were included. Fundamental frequencies (Fo), formants and vowel space areas were evaluated before surgery and 7 days and 3 months after surgery to acoustically analyze the oral vowel sounds...
June 18, 2016: Clinical and Experimental Otorhinolaryngology
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
Petros V Vlastarakos, Aaron Trinidade, Marie-Claire Jaberoo, George Mochloulis
In this article we describe the surgical management of retrosternal goiters via a limited thoracocervical approach, and we explore how the respective surgical know-how can be used in the management of the carotid blowout syndrome. Four cases involving patients who had undergone thyroidectomy via a limited thoracocervical approach are retrospectively reviewed. An acute blowout of the innominate artery managed with the same principal surgical technique is also reviewed. Three patients had a total thyroidectomy and one had a hemithyroidectomy...
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
Francesco Tartaglia, Sara Blasi, Alessandro Giuliani, Raffaele Merola, Giada Livadoti, Dimitri Krizzuk, Giovanni Tortorelli, Luciana Tromba
Authors analyze their experience of parathyroid autotransplantation during total thyroidectomy, with the purpose of seeing whether this practice influenced the rate of postoperative hypocalcemia and/or hypoparathyroidism. We identified three groups of patients: group A, consisting of 57 patients, underwent parathyroid autotransplantation during total thyroidectomy; group B consisting of 87 patients not submitted to intraoperative autotransplantation in whom, as an incidental finding, a parathyroid gland was detected in the surgical specimen; group C consisted of 100 patients who did not undergo autotransplantation and whose surgical specimens were not found to contain parathyroid glands...
April 2016: International Journal of Surgery
M Perera, L Anabell, D Page, T Harding, N Gnaneswaran, S Chan
BACKGROUND: There has been increasing emphasis on performing 'same-day' or 'out-patient' thyroidectomy to reduce associated costs. However, acceptance has been limited by the risk of potentially life-threatening post-operative bleeding. This study aimed to review current rates of post-operative bleeding in a metropolitan teaching hospital and identify risk factors. METHOD: Medical records of patients undergoing thyroidectomy between January 2007 and March 2012 were reviewed retrospectively...
January 2016: Journal of Laryngology and Otology
Ryan W Berg, Tina W Yen, Douglas B Evans, Bryan Hunt, Francisco A Quiroz, Stuart D Wilson, Tracy S Wang
BACKGROUND: Intraoperative frozen section (FS) often is performed in patients who undergo thyroid lobectomy to determine the need for completion thyroidectomy. At our institution, if FS pathology is benign, final pathology is expedited overnight. The aim of this study was to determine the utility of FS and to identify a cost-effective management algorithm for thyroid lobectomy. METHODS: A retrospective review was performed of patients who underwent thyroid lobectomy between January 2009 and May 2013...
February 2016: Surgery
Yong Wang, Qunzi Zhao, Haichao Yan, Qiuping Xie, Zhiyu Li, Ping Wang, Shaoming Xu
OBJECTIVE: To summarize the experiences of applying three-dimensional (3D) technique in scarless endoscopic thyroidectomy (SET) via anterior chest approach. METHODS: Medical records of patients who undenvent SET using 3D technique from December 2013 to May 2014 were retrospectively reviewed. A total of 32 patients who had a preoperative ultrasound-guided fine-needle aspiration cytology diagnosis of unilateral papillary thyroid carcinoma and underwent lobectomy associated with central lymph node dissection were included in this study...
March 2015: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
S C Del Duca, M G Santaguida, N Brusca, I Gatto, M Cellini, L Gargano, C Verga Falzacappa, F M Frattaroli, C Virili, M Centanni
OBJECTIVE: Thyroxine (T4) requirement after total thyroidectomy for differentiated thyroid carcinoma (DTC) is a debated issue. As most of the studies in the area have been retrospective and/or performed with heterogeneous therapeutic approaches, we designed our study to determine T4 requirement in the same patients and treatment settings, before and after total thyroidectomy. DESIGN, PATIENTS AND METHODS: This was a longitudinal study including 23 goitrous patients treated with T4 in an individually tailored fashion...
September 2015: European Journal of Endocrinology
Enrico Erdas, Fabio Medas, Francesco Podda, Silvia Furcas, Giuseppe Pisano, Angelo Nicolosi, Pietro Giorgio Calò
INTRODUCTION: Anticoagulants and antiplatelet agents are well-known risk factors for post-operative bleeding. The aim of this prospective, randomized pilot study was to evaluate the effectiveness of a topical haemostatic agent, namely TachoSil, for the prevention of postoperative bleeding in patients on antithrombotic therapy undergoing thyroidectomy. Perioperative management and some distinctive aspects of cervical haematomas were also discussed. METHODS: Between January 2012 and May 2014, all patients taking vitamin K antagonists (VKAs) or acetyl salicylic acid (ASA) scheduled for total thyroidectomy were enrolled and randomly allocated to group 1 (standard haemostasis) and group 2 (standard haemostasis + TachoSil)...
August 2015: International Journal of Surgery
Jingge Yang, Cunchuan Wang, Jinyi Li, Wah Yang, Guo Cao, Hong-Meng Wong, Hening Zhai, Weijun Liu
BACKGROUND: Natural orifice translumenal endoscopic surgery (NOTES(®); American Society for Gastrointestinal Endoscopy [Oak Brook, IL] and Society of American Gastrointestinal and Endoscopic Surgeons [Los Angeles, CA]) is gaining interest because it allows operations without skin incisions. The aim of this study was to evaluate the feasibility, safety, and cosmetic results of endoscopic thyroidectomy via the oral vestibular approach (ETOVA) compared with endoscopic thyroidectomy via the areola approach (ETAA) in patients with thyroid diseases...
June 2015: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Ki Hwan Hong, Yun Su Yang, Hyun Doo Lee, Yun Sub Yoon, Yong Tae Hong
OBJECTIVES: Voice and speech alternations that can occur after total thyroidectomy are usually due to recurrent or superior laryngeal nerve injury. These alterations may also be associated with other extralaryngeal factors, such as neck muscle dysfunction and scar contracture of the neck. We performed a prospective acoustic analysis on speech changes after surgery, in the absence of laryngeal nerve injury. METHODS: Patients aged 19 to 58 years undergoing total thyroidectomy, in the absence of laryngeal/pulmonary disease, previous neck surgery, or other malignant diseases, were recruited prospectively...
June 2015: Clinical and Experimental Otorhinolaryngology
B Abboud, G Sleilaty, T Eid
OBJECTIVE: Redo thyroid surgery is generally associated with more complications than firsthand surgery. The actual study reports a single center experience of redo thyroid surgery compared to primary bilateral thyroidectomy. STUDY DESIGN: Mono institutional retrospective study. METHODS: Institutional review of redo thyroid surgery patients (Group 2 : completion thyroidectomy and Group 3 : thyroidectomy for recurrent thyroid diseases) compared to Group 1 : primary bilateral thyroidectomy operated on during the same time interval...
November 2014: Acta Chirurgica Belgica
O S Olifirova, N N Trynov
There is a number of factors such as the thyroidectomy and limiting subtotal thyroid resection against the background of euthyroidism and initial hypothyroidism (in any extent of operation) which leads to the prediction of early postoperative hypothyroidism origin during 10 days of the postoperative peri- od. The early postoperative hypothyroidism is accompanied by activation processes of lipid peroxide oxidation and at the same time by reduction of antioxidant protection.
2015: Vestnik Khirurgii Imeni I. I. Grekova
Costanza Chiapponi, Frank Meyer, Olof Jannasch, Stephan Arndt, Patrick Stübs, Christiane J Bruns
INTRODUCTION: Studies have reported that patients often sign consent documents without understanding the content. Written paperwork, audio-visual materials, and decision aids have shown to consistently improve patients' knowledge. How informed consent should be taken is not properly taught at most universities in Germany. MATERIALS AND METHODS: In this cross-sectional study, we investigated how much information about their procedure our patients retain. In particular, it should be elucidated whether an additional conversation between patients and properly prepared medical students shortly before surgery as an adjunct to informed consent can be introduced as a new teaching unit aimed to increase the understanding of surgery by patients and students...
September 2015: World Journal of Surgery
Sait Sager, Betul Vatankulu, Ezgi Erdogan, Sanem Mut, Serkan Teksoz, Tulin Ozturk, Kerim Sonmezoglu, Bedii Kanmaz
Recent studies have reported that standardized uptake values of FDG-PET imaging might predict malignant thyroid nodules and can be used in the preoperative evaluation of thyroid lesions. The aim of our study was to evaluate FDG-PET imaging in patients with cold thyroid nodules and to compare the imaging findings with Tc-99m MIBI scans and with post-op histopathology results. Twenty-three patients (18F, 5M) with 24 nodules that were suspicious in ultrasound and cold in Tc-99m pertechnetate scan, were included in the study...
September 2015: Endocrine
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