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Total thyroidectomy

Wenbin Yu, Lijun Zhu, Guohui Xu, Yuntao Song, Guojun Li, Naisong Zhang
As a novel type of lymphatic tracer, carbon nanoparticles (CNs) were reported not to stain parathyroid glands (PGs) into black, so it may have a clinical potential in protection of PGs during thyroidectomy. The purpose of this study was to investigate the clinical application and significance of CN in protection of PGs from surrounding tissues.A total of 82 consecutive patients were enrolled into this study and were divided into CN group and control group. Parathyroid function (hypoparathyroidism and hypocalcemia) was evaluated...
October 2016: Medicine (Baltimore)
Dandan Yi, Peng Song, Tao Huang, Xiaoqiao Tang, Jianfeng Sang
Whether total thyroidectomy reduces the recurrence rate in patients with papillary thyroid microcarcinoma (PTMC) is currently controversy. Conclusions of sporadic, inconsistent, and mono-institutional studies need a meta-analysis to evaluate. 525 relevant studies were obtained from initial search on PubMed, 511 studies were excluded by inclusion and exclusion criteria. Eligible data were extracted from each included study. The Odds ratios (ORs) and 95% confidence interval (CI) were used to assess the difference in the recurrence rates between PTMC patients treated with total thyroidectomy and non-total thyroidectomy...
October 15, 2016: Oncotarget
Alborz Jooya, Joe Saliba, Audrey Blackburn, Michael Tamilia, Michael P Hier, Alex Mlynarek, Véronique-Isabelle Forest, Louise Rochon, Anca Florea, Hangjun Wang, Richard J Payne
BACKGROUND: Management decisions are not straightforward when the Ultrasound Guided Fine Needle Aspiration (USFNA) demonstrates a Bethesda score of either category III or IV, and a diagnostic hemi-thyroidectomy or a repeat USFNA (r-USFNA) could be performed. The aim of this study is to assess the effectiveness of r-USFNA in the management of indeterminate thyroid nodules by evaluating the likelihood of obtaining a definite diagnosis. METHODS: We reviewed the medical records of all patients with thyroid nodules between 2011 and 2015 at the Jewish General Hospital (Montreal, Canada)...
October 18, 2016: Journal of Otolaryngology—Head & Neck Surgery
Verena Merki, Juliane Pichler, Roland Giger, Georgios Mantokoudis
BACKGROUND: Chylothorax is a very rare but major complication in thyroid surgery and should be apparent to clinicians in this field. CASE PRESENTATION: We report a case with chylothrax after thyroid surgery in our department that drew our attention. METHODS: Systematic review of the literature to evaluate the incidence and the contributing factors of chylothorax after thyroid surgery. Database (PubMed) and hand searches to identify patients with thyroid surgery and postoperative chylothorax...
October 18, 2016: Journal of Otolaryngology—Head & Neck Surgery
Javier López-Gómez, Ma Alejandra Salazar-Álvarez, Martin Granados-Garcia
INTRODUCTION: Thyroglosal duct cyst is a common anomaly with an incidence of 7% in adults, the rate of carcinoma in TGDC is 0.7-1.6%, and are extremely rare those originated in the hyoid bone. PRESENTATION OF CASE: A 60 years old male patient, had a hard mass in the anterior neck. CT revealed a hyoid tumor. Hyoid bone resection was performed, the pathological report show a conventional papillary carcinoma in bone tissue. We rule out primary tumor in thyroid gland...
September 29, 2016: International Journal of Surgery Case Reports
Seul Gi Lee, Woo Kyung Lee, Hye Sun Lee, Jieun Moon, Cho Rok Lee, Sang Wook Kang, Jong Ju Jeong, Kee-Hyun Nam, Woong Youn Chung, Young Suk Jo, Jandee Lee
BACKGROUND: The 2015 American Thyroid Association (ATA) management guidelines for adult patients with differentiated thyroid cancer (DTC) propose the use of the modified initial risk stratification and response to therapy re-stratification systems. This study was conducted to validate the practicality of the revised guidelines for predicting tumor recurrence in patients with DTC. METHODS: Patients with papillary thyroid cancer (n=2425) who underwent total thyroidectomy with central neck node dissection with or without modified radical neck node dissection at a single institution between October 1985 and July 2009 were retrospectively enrolled...
October 17, 2016: Thyroid: Official Journal of the American Thyroid Association
Seo Ki Kim, Inhye Park, Jung-Woo Woo, Jun Ho Lee, Jun-Ho Choe, Jung Han Kim, Jee Soo Kim
BACKGROUND: In the 2015 American Thyroid Association guidelines, either lobectomy or total thyroidectomy was recommended for thyroid cancer < 4 cm without extrathyroidal extension (ETE) and lymph node (LN) metastasis. Therefore, the purpose of this study was to investigate factors predictive of bilaterality in papillary thyroid carcinoma (PTC) patients with tumor size < 4 cm. METHODS: We retrospectively reviewed 3296 conventional PTC patients who underwent total thyroidectomy with central neck dissection and/or lateral neck dissection between January 2008 and June 2015...
October 17, 2016: Thyroid: Official Journal of the American Thyroid Association
Marc Gregory Yu, Jenny Maureen Atun
Tuberculous (TB) lymphadenitis can mimic cervical node metastasis from papillary thyroid carcinoma (PTC) since the distribution and appearance of affected lymph nodes are similar. We present the case of an asymptomatic 50-year-old Filipino who sought consult for a gradually enlarging anterior neck mass and a single palpable cervical lymph node. Preoperative workup suggested a thyroid malignancy with nodal metastasis. He underwent total thyroidectomy with node dissection where histopathology confirmed follicular variant- (FV-) PTC...
2016: Case Reports in Medicine
Claudio Spinelli
Thyroid tumors affect all age groups, including children and adolescents. Malignant cancer of the thyroid is a relatively uncommon disease in pediatric age. In the recent decades the incidence of paediatric differentiated thyroid carcinoma (DTC) has increased. DTC in paediatric age is rare and has an excellent prognosis. Compared to adult counterpart, DTC in childhood presents some different features as follows: larger volume at the diagnosis, more frequent multicentricity (both mono- and bilateral), earlier local involvement of soft tissue of the neck, earlier lymph node involvement, distant metastases 3-4 times more frequent (most often in the lungs and almost always functional) and more common post-operatory recurrence; nevertheless, the prognosis of DTC in childhood is better and the survival greater than in adult...
October 13, 2016: Current Pediatric Reviews
Antonio Sitges-Serra, Lander Gallego-Otaegui, Sergio Suárez, Leyre Lorente-Poch, Assumpta Munné, Juan J Sancho
BACKGROUND: The main drawback of central neck lymph node dissection is postoperative parathyroid failure. Little information is available concerning inadvertent resection of the parathyroid glands in this setting and its relationship to postoperative hypoparathyroidism. Our aim was to determine the prevalence of inadvertent parathyroidectomy during total thyroidectomy and central neck dissection for papillary thyroid cancer and its impact on short-and long-term parathyroid function. METHODS: This was a prospective observational study of consecutive patients undergoing first-time total thyroidectomy with a central neck dissection for papillary carcinoma >10 mm...
October 13, 2016: Surgery
Friedhelm Raue, Karin Frank-Raue
Thyroid cancer is the most common endocrine malignancy. Differentiated thyroid cancer (DTC) with the two subtypes, papillary thyroid cancer (PTC) and follicular thyroid cancer (FTC), is the most frequent subtype of thyroid cancer; more rare subtypes are medullary thyroid cancer (MTC) and anaplastic thyroid cancer (ATC). The incidence of DTC has increased rapidly in recent years due to the more frequent use of imaging methods such as ultrasound of the neck and fine-needle aspiration (FNA) of thyroid nodules...
October 15, 2016: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
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...
October 13, 2016: World Journal of Surgery
Daniel J Rocke, David P Goldstein, John R de Almeida
Importance: Intraoperative nerve monitoring (IONM) of the recurrent laryngeal nerve (RLN) is used as a tool to decrease the rate of nerve injury, although study findings are divergent on IONM efficacy. The cost-effectiveness of this approach to total thyroidectomy has not been well studied. Objective: To determine whether IONM is a cost-effective intervention in the setting of total thyroidectomy. Design and Setting: This study creates a decision-tree model of total thyroidectomy to analyze, from a societal perspective, the cost-effectiveness of universal IONM (ie, use in every case) vs selective IONM (ie, high-risk cases including reoperative cases, substernal or toxic goiters, and cases with known cancer) vs no IONM (visual identification only)...
October 13, 2016: JAMA Otolaryngology—Head & Neck Surgery
Joseph C Dort, D Gregory Farwell, Merran Findlay, Gerhard F Huber, Paul Kerr, Melissa A Shea-Budgell, Christian Simon, Jeffrey Uppington, David Zygun, Olle Ljungqvist, Jeffrey Harris
Importance: Head and neck cancers often require complex, labor-intensive surgeries, especially when free flap reconstruction is required. Enhanced recovery is important in this patient population but evidence-based protocols on perioperative care for this population are lacking. Objective: To provide a consensus-based protocol for optimal perioperative care of patients undergoing head and neck cancer surgery with free flap reconstruction. Evidence Review: Following endorsement by the Enhanced Recovery After Surgery (ERAS) Society to develop this protocol, a systematic review was conducted for each topic...
October 13, 2016: JAMA Otolaryngology—Head & Neck Surgery
Xilin Nie, Zhuo Tan, MingHua Ge, LieHao Jiang, JiaFeng Wang, ChuanMing Zheng
Objective: The aim of this study was to investigate the incidence and risk factors for lateral lymph node metastasis (LLNM) in patients with papillary thyroid carcinoma (PTC). Subjects and methods: 356 patients diagnosed with PTC who underwent total thyroidectomy and central lymph node dissection and lateral lymph node dissection between January 2005 and December 2011 were enrolled. The relation between LLNM and clinicopathological features such as gender, age, tumor size, tumor spread, psammoma bodies, tumor multifocality, extrathyroidal extension (ETE), unilateral or bilateral disease, tumor primary location and central lymph node metastases (CLNM) was analyzed...
October 10, 2016: Archives of Endocrinology and Metabolism
G Scerrino, M Attard, C Lo Piccolo, A Attard, G I Melfa, C Raspanti, M Zarcone, S Bonventre, S Mazzola, G Gulotta
INTRODUCTION AND OBJECTIVES: Primary hyperparathyroidism (PHPT) can be found in concomitance with thyroid disease (TD) in a high frequency of cases. In this context the diagnostic exams for localizing the enlarged parathyroid(s) gland(s) could be less reliable or nonconclusive. Moreover, the thyroid carcinoma seems to be more frequent compared to that isolated thyroid desease and, therefore, carefully investigated. The main goal of the present study is to evaluate which diagnostic tool (US, MIBI) is more reliable for localizing the site of the PTH hypersecretion and to confirm if it is always advantageous a combination of both exams...
May 2016: Il Giornale di Chirurgia
Zdeňka Límanová, Jan Jiskra
Cardiovascular system is essentially affected by thyroid hormones by way of their genomic and non-genomic effects. Untreated overt thyroid dysfunction is associated with higher cardiovascular risk. Although it has been studied more than 3 decades, in subclinical thyroid dysfunction the negative effect on cardiovascular system is much more controversial. Large meta-analyses within last 10 years have shown that subclinical hyperthyroidism is associated with higher cardiovascular risk than subclinical hypothyroidism...
2016: Vnitr̆ní Lékar̆ství
Marianna Grigerová, Martin Griger, Emília Mojtová, Ján Podoba
Low risk differentiated thyroid microcarcinoma therapy is a controversial area of thyroid tumor management. Major international medical societies and reputable institutes consider lobectomy to be sufficient therapeutic intervention for the pT1a cN0cM0 stage of papillary thyroid microcarcinoma. However different views and therapeutic strategies exist and result in unnecessary overtreatment and worsening of patients quality of life. We researched the course of the differentiated thyroid microcarcinoma in patients using different therapeutic strategies: lobectomy, total thyroidectomy, total thyroidectomy with central compartment prophylactic lymphadenectomy and total thyroidectomy followed by radioactive iodine treatment...
2016: Vnitr̆ní Lékar̆ství
Fausto Famà, Marco Cicciù, Francesca Polito, Antonio Cascio, Maria Gioffré-Florio, Arnaud Piquard, Olivier Saint-Marc, Alessandro Sindoni
INTRODUCTION: Parathyroid autotransplantation is an easy procedure with a low complication rate. We adopted the transplantation into the sternocleidomastoid muscle, which allows an easier and time-saving surgical procedure using the same surgical incision. METHODS: In this study, we retrospectively reviewed the records of 396 consecutive patients, who underwent total thyroidectomy for benign thyroid disease. In all cases in which a parathyroid was damaged or inadvertently removed, the gland was transplanted; before the autotransplantation, the parathyroid tissue was put in a cell culture nutrient solution for 5 min, afterward fragmented, and then was transplanted in the sternocleidomastoid muscle...
October 12, 2016: World Journal of Surgery
Yul Hwangbo, Jung Min Kim, Young Joo Park, Eun Kyung Lee, You Jin Lee, Do Joon Park, Young Sik Choi, Kang Dae Lee, Seo Young Sohn, Sun Wook Kim, Jae Hoon Chung, Dong Jun Lim, Min Hee Kim, Min Joo Kim, Young Suk Jo, Min Ho Shong, Sung-Soo Koong, Jong Ryeal Hahm, Jung Hwa Jung, Ka Hee Yi
CONTEXT: Small papillary thyroid cancer (PTC) generally has excellent prognosis. However, the long-term recurrence is not uncommon, which sometimes leads to morbidity or mortality. OBJECTIVE: To identify the high-risk factors for long-term recurrence in patients with small PTC by stratifying their pathologic characteristics. DESIGN, SETTING, AND PATIENTS: We conducted a nationwide, retrospective, multicenter study including 3,282 patients with PTC size ≤2 cm from 9 high volume hospitals in Korea...
October 12, 2016: Journal of Clinical Endocrinology and Metabolism
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