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Total thyroidectomy

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https://www.readbyqxmd.com/read/29155510/in-situ-preservation-of-parathyroid-glands-advanced-surgical-tips-for-prevention-of-permanent-hypoparathyroidism-in-thyroid-surgery
#1
Radan Dzodic, Nada Santrac
Hypoparathyroidism (HPT) is one of the most frequentand severe complications of thyroid surgery. It is caused by intraoperative damage, devascularization or accidental removal of the parathyroid glands (PTGs). The incidence of postoperative HPT is directly proportional to surgery extent and surgeon's experience. After 40 years of experience in thyroid surgery, the first author summarizes the already known surgical steps in thyroid surgery and adds some useful practical tips for in situ preservation of PTGs...
July 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29151324/thyroid-malignancy-risk-in-different-clinical-thyroid-diseases
#2
Ahmet Dirikoç, Sevgül Fakı, Hüsniye Başer, Didem Özdemir, Cevdet Aydın, Reyhan Ersoy, Mehmet Kılıç, Aydan Kılıçarslan, Bekir Çakır
Background/aim: To evaluate the malignancy risk of thyroid nodules in different clinical thyroid diseases. Materials and methods: Patients who underwent thyroidectomy between 2007 and 2014 were grouped as euthyroid, hypothyroid, and hyperthyroid. Further classification was made depending on the presence of solitary/multiple thyroid nodules. Results: Among 2870 patients, 1719 (59.9%) were euthyroid, 962 (33.5%) were hyperthyroid, and 189 (6.6%) were hypothyroid. Overall malignancy was detected in 980 (34.1%) patients...
November 13, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29147894/chest-x-ray-prior-to-thyroidectomy-is-it-really-needed
#3
Alexandra Mikhael, Rushad Patell, Michael Tabet, James Bena, Eren Berber, Christian Nasr
BACKGROUND: Chest X-ray (CXR) prior to thyroid surgery continues to be routinely obtained at some institutions despite the lack of evidence for its utility. This study aimed to determine the utility of preoperative CXR in patients undergoing thyroidectomy at a single institution. METHODS: In total, 594 thyroidectomy patients were included in the study. Demographics, CXR findings, anesthesia records and pathologic data were assessed. We investigated whether difficult intubation or cancer stage correlated with the presence of CXR abnormalities...
November 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29146231/is-hungry-bone-syndrome-a-cause-of-postoperative-hypocalcemia-after-total-thyroidectomy-in-thyrotoxicosis-a-prospective-study-with-bone-mineral-density-correlation
#4
Poongkodi Karunakaran, Chandrasekaran Maharajan, Srinivasan Ramalingam, Suresh Venkatesh Rachmadugu
BACKGROUND: Hungry bone syndrome is a well-established cause of postoperative hypocalcemia in thyrotoxicosis. To date, the incidence of hungry bone syndrome after total thyroidectomy is unclear. This prospective study examined the incidence of postthyroidectomy hungry bone syndrome and its correlation with preoperative bone mineral density. METHODS: Forty thyrotoxic subjects (Group A; age: mean ± SD; 36.5 ± 9.8 years) and 40 euthyroid controls with benign thyroid nodules (Group B) undergoing total thyroidectomy were evaluated for preoperative bone mineral density and serum calcium, magnesium, phosphorus, parathyroid hormone, alkaline phosphatase, and 25-Hydroxy Vitamin D serially...
November 14, 2017: Surgery
https://www.readbyqxmd.com/read/29146229/evaluating-the-projected-surgical-impact-of-reclassifying-noninvasive-encapsulated-follicular-variant-of-papillary-thyroid-cancer-as-noninvasive-follicular-thyroid-neoplasm-with-papillary-like-nuclear-features
#5
Rajshri Mainthia, Heather Wachtel, Yufei Chen, Elizabeth Mort, Sareh Parangi, Peter M Sadow, Carrie C Lubitz
BACKGROUND: The reclassification of noninvasive encapsulated follicular variant of papillary thyroid cancer to noninvasive follicular thyroid neoplasm with papillary-like nuclear features will reduce nonefficacious and potentially harmful care. Reclassification is estimated in 18.6% of patients with papillary thyroid carcinoma; we aimed to quantify the implications of this change. METHODS: Pathology reports from April 2006 to April 2016 were reviewed to isolate cases that would have been designated as neoplasm with papillary-like nuclear features...
November 13, 2017: Surgery
https://www.readbyqxmd.com/read/29145466/serum-tsh-levels-as-a-predictor-of-malignancy-in-thyroid-nodules-a-prospective-study
#6
Lenara Golbert, Ana Patrícia de Cristo, Carlo Sasso Faccin, Mauricio Farenzena, Heloísa Folgierini, Marcia Silveira Graudenz, Ana Luiza Maia
BACKGROUND: The role of serum TSH concentrations as a predictor of malignancy of thyroid nodule remains unclear. OBJECTIVE: To prospectively evaluate the usefulness of serum TSH levels as a predictor of malignancy in thyroid nodules. METHODS: Patients with thyroid nodule(s) who underwent fine-needle aspiration biopsy under ultrasonographic guidance in a tertiary, university-based hospital were consecutively evaluated. Patients with known thyroid cancer and/or patients receiving thyroid medication were excluded...
2017: PloS One
https://www.readbyqxmd.com/read/29144811/concordance-of-preoperative-clinical-stage-with-pathological-stage-in-patients-%C3%A2-45-years-with-well-differentiated-thyroid-cancer
#7
Natalie A Calcatera, Waseem Lutfi, Paritosh Suman, Nicholas R Suss, Chi-Hsiung Wang, Richard A Prinz, David J Winchester, Tricia A Moo-Young
OBJECTIVE: Clinical stage (cStage) in thyroid cancer determines extent of surgical therapy and completeness of resection. Pathologic stage (pStage) is an important determinant of outcome. The rate of discordance between clinical and pathologic stage in thyroid cancer is unknown. METHODS: The National Cancer Data Base (NCDB) was queried to identify 27,473 patients ≥45 years old with cStage I through IV differentiated thyroid cancer undergoing surgery from 2008-2012...
November 16, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/29144799/parathyroid-function-after-total-thyroidectomy-a-randomized-clinical-trial-concerning-the-influence-of-the-surgical-technique
#8
Theodossis S Papavramidis, Olympia Anastasiou, Ioannis Pliakos, George Kotsovolis, Stavros Panidis, Antonios Michalopoulos
Background Thyroidectomy impairs parathyroid function, even if it does not necessarily lead to postoperative clinical hypocalcaemia. This study is prospective and evaluates the PTH function in non-clinically symptomatic patients after total thyroidectomy performed by two different techniques. Materials and Methods Prospective randomized clinical trial including 269 patients undergoing classic (group A) or harmonic scalpel (group B) total thyroidectomy. Preoperatively and at 48 hours biochemical analysis was performed...
November 16, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/29144798/pancreas-metastases-from-papillary-thyroid-carcinoma-a-review-of-the-literature
#9
Maja Davidson, Randall J Olsen, April A Ewton, Richard J Robbins
OBJECTIVE: Although loco-regional metastases occur in 5-10% of patients with papillary thyroid cancer (PTC), distant metastases are rare, especially to the pancreas. Here we review the literature regarding metastases to the pancreas from PTC and present an illustrative patient. METHODS: The literature search was performed through www.pubmed.org . The information regarding our illustrative case was obtained from the medical records of our institution. RESULTS: Since 1991, 11 cases of pancreas metastases of PTC have been reported...
November 16, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/29143715/scar-satisfaction-and-body-image-in-thyroidectomy-patients-prospective-study-in-a-tertiary-referral-centre
#10
P Sethukumar, D Ly, Z Awad, N S Tolley
BACKGROUND: This study is the first to evaluate scar satisfaction and body image in thyroidectomy patients using validated assessment tools. METHODS: A total of 123 thyroidectomy patients were recruited over 8 months. Both patients and clinicians completed assessment tools that included: the Manchester Scar Scale (to measure scar perception), Dysmorphic Concern Questionnaire (to assess body image), Body Dysmorphic Concern Questionnaire (to screen for body dysmorphic disorder) and EQ-5D (to measure life quality)...
November 16, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/29142855/single-port-thoracoscopic-treatment-of-thoracic-duct-injury-after-thyroidectomy-with-neck-dissection
#11
Serkan Teksoz, Ezel Ersen, Akif Enes Arikan, Sina Ferahman, Kamil Kaynak, Gianlorenzo Dionigi, Yusuf Bukey
Chylous leakage is a complication of thyroidectomy accompanied by bilateral neck dissection with incidence of 0.5-6.2%. A 51-year-old female patient underwent total thyroidectomy, bilateral and central neck dissection for papillary thyroid carcinoma. In post-operative 4(th) day, left sided chylous leakage was observed as 1,500 cc/day through neck drain. Leakage did not cease after 1-month conservative treatment so single port thoracoscopic intervention was performed. Under general anesthesia, patient was placed in left lateral decubitus position...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142854/skin-metastasis-on-the-neck-an-unusual-presentation-of-recurrence-of-papillary-thyroid-carcinoma
#12
Selen Soylu, Akif Enes Arikan, Serkan Teksoz, Murat Ozcan, Yusuf Bukey
Skin metastasis of papillary thyroid carcinoma (PTC) is rare. Here, two cases of skin metastases of PTC are presented. Both of the patients were females, one is 83 and the other is 65 years old. The patients were admitted to the hospital with a movable skin lesion on anterior neck region. Free T3 and T4 levels were in normal levels and TSH levels were low in both patients. The 83-year-old patient underwent total thyroidectomy due to papillary thyroid cancer and received (131)I ablation therapy and then thyroid suppression therapy...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142853/silk-suture-reaction-in-thyroid-surgery
#13
Selen Soylu, Akif Enes Arikan, Serkan Teksoz, Murat Ozcan, Yusuf Bukey
Silk suture reaction (i.e., a benign granulomatous inflammatory foreign body reaction) is a rare complication of thyroid surgery. Here, two cases of post-thyroidectomy suture reaction are presented. Both of the patients were female, one is 48 and the other is 34 years old. The patients were presented with neck swelling and leakage of serous fluid from the Kocher's incision. Both patients had normal free T4, free T3, and TSH values. The 48-year-old female patient had a right subtotal and left near-total thyroidectomy 6 years ago and the other had bilateral total thyroidectomy 6 years ago...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142837/preoperative-management-in-patients-with-graves-disease
#14
REVIEW
Eliana Piantanida
Graves' disease is the most frequent cause of hyperthyroidism in iodine-sufficient geographical areas and is characterized by the presence in patients' serum of autoantibodies directed against the thyrotropin receptor (TRAb) that cause overproduction and release of thyroid hormones. Clinical presentation results from both hyperthyroidism and underlying autoimmunity. The diagnosis is based on characteristic clinical features and biochemical abnormalities. If serum thyrotropin (TSH) is low, serum free thyroxine (FT4) and free triiodothyronine (FT3) concentrations should be measured to distinguish between subclinical (with normal circulating thyroid hormones) and overt hyperthyroidism (with increased circulating thyroid hormones)...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142835/trachway-video-intubating-stylet-allows-for-optimization-of-electromyographic-endotracheal-tube-placement-for-monitored-thyroidectomy
#15
Pi-Ying Chang, Pin-Yang Hu, Yi-Chu Lin, Hsiu-Ya Chen, Feng-Yu Chiang, Che-Wei Wu, Gianlorenzo Dionigi, I-Cheng Lu
Background: Endotracheal tube-based surface electrodes are now commonly applied to measure evoked electromyographic (EMG) response of the vocal cord during monitored thyroidectomy. The aim of the study was to determine the incidence of difficult intubation and to assess the effectiveness of using video-assisted intubating stylet (Trachway) for EMG tube placement in patients undergoing monitored thyroidectomy. Methods: Medical records were collected from consecutive patients undergoing thyroid surgery before and after implementation of the protocol...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142834/two-stage-thyroidectomy-in-the-era-of-intraoperative-neuromonitoring
#16
Christos Christoforides, Ioannis Papandrikos, Georgios Polyzois, Nikolaos Roukounakis, Gianlorenzo Dionigi, Kyriakos Vamvakidis
Background: The use of intraoperative neuromonitoring (IONM) provides surgeons with real time information about recurrent laryngeal nerves (RLN) functional integrity. Hence, allowing them to modify the initially scheduled bilateral procedure, to a two-stage thyroidectomy in cases of loss of signal (LOS) on the first side of resection resulting in minimization of bilateral RLN injury. The purpose of our study was to present our results since the implementation of the above mentioned process in both malignant and benign thyroid disease...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142831/what-adds-valsalva-maneuver-to-hemostasis-after-trendelenburg-s-positioning-during-thyroid-surgery
#17
Murat Ozdemir, Ozer Makay, Gokhan Icoz, Mahir Akyildiz
Background: Bleeding after thyroidectomy is life-threatening. The aim of the study was to evaluate whether controlling of further bleeding with Valsalva maneuver following Trendelenburg's positioning has an impact on hemostasis. Methods: This prospective study included 68 consecutive patients undergoing thyroidectomy. Study protocol consisted of performing manual intra-abdominal pressure increase and Valsalva maneuver to check hemostasis and treating any bleeding point identified, after Trendelenburg's positioning...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142830/parathyroid-hormone-and-serum-calcium-levels-measurements-as-predictors-of-postoperative-hypocalcemia-in-total-thyroidectomy
#18
Mohammed Algarni, Rajab Alzahrani, Gianlorenzo Dionigi, Al-Hakami Hadi, Haia AlSubayea
Background: The rules of quantitative measures such as parathyroid hormone (PTH) levels in the first hours following total thyroidectomy have since been validated repeatedly. Such measures play an integral rule in identifying patients at significant risk for hypocalcaemia and have allowed for earlier supplementation of these patients with calcium with or without vitamin D. Methods: A retrospective analysis was conducted of 40 consecutive patients with well differentiated thyroid cancer (WDTC) who underwent total thyroidectomy without central neck dissection (CND) as an initial surgery and no comorbidity at King Abdulaziz Medical City (National Guard hospital), between July 2011 and July 2012...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29138707/jejunojejunal-intussusception-due-to-metastatic-melanoma-seven-years-after-the-primer
#19
Alexander Giakoustidis, Thomas Goulopoulos, Anastasios Boutis, George Kavvadias, Aristidis Kainantidis, Thomas Zaraboukas, Dimitrios Giakoustidis
Intestinal intussusception in adults is a rare medical condition accounting for less than 5% of all intussusceptions. Herein we present a 45-year-old patient with a history of abdominal pain and loss of weight. CT scan revealed jejunojejunal intussusceptions. The patient was subjected to exploratory operation and small intestine resection due to a mass causing intestinal intussusception. Pathology confirmed suspected diagnosis of metastatic melanoma to small intestine secondary to melanoma, 7 years after the initial manifestation...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/29137085/current-trends-of-practical-issues-concerning-micropapillary-thyroid-carcinoma-the-korean-society-of-thyroid-head-and-neck-surgery
#20
Yoon Se Lee, Byung-Joo Lee, Hyun Joon Hong, Kang-Dae Lee
Although several thyroid associations have published various guidelines, controversies especially in cases of micropapillary thyroid cancer (MPTC) still exist. This survey was designed to collect information about diagnostic tests and treatments performed on patients with MPTC and help identify current trends in thyroid surgery.We developed questionnaires about the management methods for MPTC, which were used to identify factors related to indications of fine needle aspiration (FNA), type of surgery, and central lymph node dissection (CLND)...
November 2017: Medicine (Baltimore)
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