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Thyroidectomy complications

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
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
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
Ibrahim Ali Ozemir, Ferman Ozyalvac, Gorkem Yildiz, Tunc Eren, Zeynep Aydin-Ozemir, Orhan Alimoglu
BACKGROUND: Diabetes mellitus may cause degeneration in the myelin and/or axonal structures of peripheral nerves. The aim of this study was to investigate the effects of diabetic neuropathy on intraoperative neuromonitoring findings such as latency and amplitude values of the recurrent laryngeal nerves during thyroidectomy. To our knowledge this is the first study to report comparison of the electrophysiologic features of diabetic and non-diabetic patients. MATERIALS AND METHODS: One-hundred-and-eleven consecutive patients who received neuromonitoring during thyroidectomy between 2013 and 2015 were included to study...
October 5, 2016: International Journal of Surgery
Enrico Maria Zardi, Maria Elena Pipita, Antonella Afeltra
Mediastinal syndromes are a group of disorders involving the anatomical structures of the mediastinum. An increase in the incidence of this syndrome has been observed following the widespread use of diagnostic imaging. In the present study, three different cases of mediastinal syndrome, one of which was complicated by superior vena cava syndrome, are discussed. The treatment in the three cases was dependent on the etiology. While a patient with goiter experienced resolution of the symptoms following thyroidectomy, and a patient with lymphoma experienced beneficial effects following medical treatment, the patient with lymph node metastasis caused by a gastric tumor succumbed to the disease...
October 2016: Experimental and Therapeutic Medicine
Urte Kunz-Zurbuchen, Heinz Johannes Buhr, Hubert G Hotz, Martin E Kreis, Kai S Lehmann
PURPOSE: To evaluate the rate of surgical complications during the change from subtotal resection to hemithyroidectomy or thyroidectomy over a period of 17 years. METHODS: All operations for benign goiter at our hospital were analyzed for the periods 1996-2002 (Group 1) and 2003-2012 (Group 2). The groups were compared for recurrent laryngeal nerve damage, hypocalcemia, and other surgical complications directly postoperatively. RESULTS: In total, 1462 patients were operated on for goiter between 1996 and 2012...
September 19, 2016: Asian Journal of Surgery
Akihiro Nakajo, Hideo Arima, Munetsugu Hirata, Yoshie Yamashita, Yoshiaki Shinden, Naoki Hayashi, Yota Kawasaki, Takaaki Arigami, Yasuto Uchikado, Shinichiro Mori, Yuko Mataki, Masahiko Sakoda, Yuko Kijima, Yoshikazu Uenosono, Kosei Maemura, Shoji Natsugoe
INTRODUCTION: Endoscopic thyroidectomy is a well-established surgical technique that is mainly performed for benign thyroid disease. We considered that endoscopic surgery could also be widely indicated for the treatment of thyroid cancer. We herein describe our new bidirectional approach of video-assisted neck surgery (BAVANS) for complete central node dissection in endoscopic thyroid cancer surgery. METHODS: BAVANS involves two different directional pathways to the cervical lesion...
September 21, 2016: Asian Journal of Endoscopic Surgery
A Minni, D Rosati, C Cavaliere, A De Carlo, G Illuminati, V Scarano Catanzaro, M Bodoni
OBJECTIVE: The aim of this randomized study is to evaluate the real benefits of the FOCUS Harmonic Scalpel in total thyroidectomies compared with conventional ligation, regarding operative time, postoperative blood loss, length of stay and complications. Furthermore, as never seen in other studies, we studied the effects of using the FOCUS during thyroidectomy analyzing the vocal production of patients before and after surgery. PATIENTS AND METHODS: We enrolled 361 patients who underwent total thyroidectomy from 2008 to 2014...
September 2016: European Review for Medical and Pharmacological Sciences
Peter Donovan, Donald McLeod, Richard Little, Louisa Gordon
OBJECTIVE: Little data exists about the most cost-effective primary treatment for Graves' disease. We performed a cost-utility analysis comparing radioactive iodine [RAI]; antithyroid drugs [ATD]); and total thyroidectomy (TT) as first-line therapy for Graves' disease in England and Australia. METHODS: We used a Markov model to compare lifetime costs and benefits (quality adjusted life-years [QALYs]). The model included efficacy, rates of relapse and major complications associated with each treatment, and alternative second-line therapies...
September 15, 2016: European Journal of Endocrinology
Qing-Qing He, Jian Zhu, Da-Yong Zhuang, Zi-Yi Fan, Lu-Ming Zheng, Peng Zhou, Lei Hou, Fang Yu, Yan-Ning Li, Lei Xiao, Xue-Feng Dong, Gao-Feng Ni
BACKGROUND: A large proportion of the patients with papillary thyroid microcarcinoma are young women. Therefore, minimally invasive endoscopic thyroidectomy with central neck dissection (CND) emerged and showed well-accepted results with improved cosmetic outcome, accelerated healing, and comforting the patients. This study aimed to evaluate the safety and effectiveness of robotic total thyroidectomy with CND via bilateral axillo-breast approach (BABA), compared with conventional open procedure in papillary thyroid microcarcinoma...
2016: Chinese Medical Journal
Khalid Hussain Al-Qahtani, Mutahir A Tunio, Mushabbab Al Asiri, Yasser Bayoumi, Ali Balbaid, Naji J Aljohani, Hanadi Fatani
INTRODUCTION: The aim of this study was to evaluate the treatment outcomes of differentiated thyroid cancer in Saudi patients aged above 60 years. MATERIALS AND METHODS: Comparative analysis was performed in 252 patients aged 46-60 years (Group A) and 118 patients aged above 60 years (Group B), who had thyroidectomy, radioactive iodine-131, and thyroid-stimulating hormone suppression therapy between July 2000 and December 2012. Different clinicopathological features, treatment, complications, disease-free survival, and overall survival rates were compared...
2016: Clinical Interventions in Aging
Vinuta Mohan, Robert Lind
Graves' disease is the most common cause of hyperthyroidism. If left untreated, patients may have multiple systemic complications such as cardiac, reproductive, and skeletal disease. Thionamides, such as methimazole and propylthiouracil, and I(131) iodine ablation are the most commonly prescribed treatment for Graves' disease. Total thyroidectomy is often overlooked for treatment and is usually only offered if the other options have failed. In our case, we discuss a patient who was admitted to our medical center with symptomatic hyperthyroidism secondary to long-standing Graves' disease...
2016: Journal of Community Hospital Internal Medicine Perspectives
Yong Wang, Xing Yu, Ping Wang, Chundi Miao, Qiuping Xie, Haichao Yan, Qunzi Zhao, Maolin Zhang, Cheng Xiang
BACKGROUND: Transoral endoscopic approach is the natural orifice surgery applied in thyroidectomy to achieve an excellent cosmetic result. Recurrent laryngeal nerve (RLN) injury is the most common complication and little advancement was achieved in the previous clinical studies of transoral thyroid surgery. Herein, we introduced the method of intraoperative neuromonitoring (IONM) for transoral endoscopic thyroid surgery. MATERIALS AND METHODS: Patients with thyroid carcinoma received transoral endoscopic thyroid surgery through vestibular approach (TOETVA) for thyroidectomy and central node dissection (CND)...
September 1, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Tianpeng Hu, Zhaowei Meng, Guizhi Zhang, Qiang Jia, Jian Tan, Wei Zheng, Renfei Wang, Xue Li, Na Liu, Pingping Zhou, Arun Upadhyaya
Radioactive iodine (RAI) is considered to be related with hematologic changes. This study aimed to evaluate influence of the first RAI ablation on peripheral complete blood count (CBC) in patients with differentiated thyroid cancer (DTC).Data of CBC at baseline and 6 months after RAI were obtained in 385 patients with DTC with approximately 3700 MBq I (ranging 2220-7585 MBq). Further comparison was done in 196 patients with 1-month postablation data available. Routine blood examinations were performed to determine impact of RAI on white blood cell (WBC), red blood cell (RBC), hemoglobin, platelet, neutrophil, lymphocyte, and monocyte in both sexes...
August 2016: Medicine (Baltimore)
Jianyong Lei, Jinqiang Zhu, Zhihui Li, Rixiang Gong, Tao Wei
OBJECTIVE: We sought to evaluate and compare the outcomes of different surgical protocols for papillary thyroid cancer (PTC) located in the isthmus in a retrospective intention-to-treat analysis. PATIENTS AND METHODS: The data of 3,068 patients who received thyroidectomy due to thyroid cancer in our center were reviewed. Of these, 103 patients had a dominant carcinoma located in the isthmus. Various baseline and tumor characteristics and surgical outcomes were evaluated and compared with respect to the different surgical protocols (85 cases with total thyroidectomy and 18 cases with less-than-total thyroidectomy)...
2016: OncoTargets and Therapy
Oscar Vidal, David Saavedra-Perez, Mauro Valentini, Emiliano Astudillo, Laureano Fernández-Cruz, Juan C García-Valdecasas
BACKGROUND: We compared surgical outcomes of LigaSure™ Small Jaw, which is a multifunctional thermal device that incorporates a tissue divider versus LigaSure Precise™ in thyroid surgery. METHODS: A retrospective, single-center study was carried out in an acute-care teaching hospital in Barcelona, Spain. Between January 2008 and June 2015, consecutive patients scheduled for total thyroidectomy were included in the study. Surgical outcomes were operative time, length of skin incision, use of a suction drain, intraoperative bleeding, postoperative complications and length of hospital stay...
August 23, 2016: International Journal of Surgery
Guven Baris Cansu, B Bakar, T Bakar, B P Cengiz
OBJECTIVE: Suture granuloma, the rare complication of thyroidectomy, results from the use of nonabsorbable suture materials. Despite its typical ultrasound images and benign course, it carries utmost importance in the diff erential diagnosis of lymph nodes, recurrent nodules, and recurrence in the case of thyroid cancers. Subject and Results. Fifty four years old female patient, who underwent bilateral thyroidectomy in July 2010, was diagnosed with multinodular goiter and incidentally discovered micropapillary carcinoma (2 mm)...
July 2016: Endocrine Regulations
Guanghui Zhu, Xueli Zhang, Zhiqiang Tang, Zhanhai Tan, Jianrong Chen, Yuanzhou Shan
BACKGROUND: Transareola single-site laparoendoscopic thyroidectomy (TASSET) is a rapidly advancing minimally invasive procedure. The purpose of this study was to evaluate the learning curve for TASSET. SUBJECTS AND METHODS: Forty-five consecutive patients were prospectively divided into group 1 (initial phase), group 2 (intermediate phase), and group 3 (advanced phase) according to their surgical order (15 patients in each group). The operative time, operative blood loss, duration of hospital stay, postoperative pain, and postoperative complications were compared using phases...
October 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
S A R Nouraei, J S Virk, S E Middleton, P Aylin, A Mace, F Vaz, H Kaddour, A Darzi, N S Tolley
OBJECTIVES: Thyroid conditions are common and their incidence is increasing. Surgery is the mainstay treatment for many thyroid conditions, and understanding its utilisation trends and morbidity are central to improving patient care. DESIGN: An N=near-all analysis of the English administrative dataset to identify trends in thyroid surgery specialisation, volume-outcome relationships, and the incidence and risk factors for short- and long-term morbidity. MAIN OUTCOME MEASURES: Between 2004 and 2012, 72594 patients underwent elective thyroidectomy in England...
August 20, 2016: Clinical Otolaryngology
A Bergenfelz, A F Salem, H Jacobsson, E Nordenström, M Almquist
BACKGROUND: Vocal cord palsy occurs in 3-5 per cent of patients after thyroidectomy. To reduce this complication, intraoperative nerve monitoring (IONM) has been introduced, although its use remains controversial. This study investigated the risk of postoperative vocal cord palsy with and without the use of intermittent IONM. METHODS: Patients registered in the Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal Surgery, 2009-2013, were included. Early palsy of the recurrent laryngeal nerve was diagnosed within 6 weeks after surgery...
August 18, 2016: British Journal of Surgery
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