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Thyroidectomy complications

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https://www.readbyqxmd.com/read/29445610/monitored-transoral-endoscopic-thyroidectomy-via-long-monopolar-stimulation-probe
#1
Gianlorenzo Dionigi, Che-Wei Wu, Ralph P Tufano, Antonio Giacomo Rizzo, Angkoon Anuwong, Hui Sun, Paolo Carcoforo, Cancellieri Antonino, Mattia Portinari, Hoon Yub Kim
This video aimed to describe the role of intraoperative neuromonitoring (IONM) during transoral endoscopic thyroidectomy vestibular approach (TOETVA) with emphasis given to IONM technical and technological notes, the identification of recurrent laryngeal nerve (RLN). Standardized technique of IONM consist in identifying and monitoring both the vagus nerve and the RLNs before and after resection (V1, V2, R1, R2). According to this report, IONM during TOETVA is feasible and safe in providing identification and function of laryngeal nerves...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29444706/bilateral-piriform-sinus-fistulas-a-case-study-and-review-of-management-options
#2
Deanna Lammers, Ross Campbell, Jorge Davila, Johnna MacCormick
BACKGROUND: Piriform sinus fistulas occur due to developmental abnormalities of the third and fourth branchial arches, and almost always occur unilaterally. They generally present as recurrent abscesses in the anterior-inferior neck, with concurrent thyroiditis. They have conventionally been managed with complete removal of the sinus tract, and thyroidectomy if required; however, endoscopic approaches have been increasingly favored. Herein we describe a case of bilateral piriform sinus fistulas, and present a review of the literature concerning their endoscopic management...
February 14, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29417651/thyroidectomy-in-patients-who-have-undergone-gastric-bypass-surgery
#3
David Goldenberg, Robert L Ferris, Maisie L Shindo, Ashok Shaha, Brendan Stack, Ralph P Tufano
BACKGROUND: Morbid obesity is a chronic condition that may be challenging to treat. Gastric bypass surgery is used to treat morbid obesity and its complications. Hypocalcemia, a known complication after thyroidectomy, is usually transient and treatable. There is a growing body of literature indicating that patients with previous gastric bypass surgery are at an increased risk for recalcitrant, symptomatic hypocalcemia after thyroidectomy. The management of hypocalcemia in patients with prior gastric bypass surgery may be exceedingly difficult...
February 8, 2018: Head & Neck
https://www.readbyqxmd.com/read/29405252/randomized-clinical-trial-of-intraoperative-parathyroid-gland-angiography-with-indocyanine-green-fluorescence-predicting-parathyroid-function-after-thyroid-surgery
#4
J Vidal Fortuny, S M Sadowski, V Belfontali, S Guigard, A Poncet, F Ris, W Karenovics, F Triponez
BACKGROUND: Hypoparathyroidism, the most common complication after thyroid surgery, leads to hypocalcaemia and significant medical problems. An RCT was undertaken to determine whether intraoperative parathyroid gland angiography with indocyanine green (ICG) could predict postoperative hypoparathyroidism, and obviate the need for systematic blood tests and oral calcium supplementation. METHODS: Between September 2014 and February 2016, patients who had at least one well perfused parathyroid gland on ICG angiography were randomized to receive standard follow-up (measurement of calcium and parathyroid hormone (PTH) on postoperative day (POD) 1 and systematic supplementation with calcium and vitamin D; control group) or no supplementation and no blood test on POD 1 (intervention group)...
February 6, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29397628/-a-comparative-study-of-endoscopic-and-traditional-open-surgery-in-the-treatment-of-papillary-thyroid-carcinoma
#5
Q Z Zhao, Y Wang, P Wang
Objective: To evaluate the feasibility, safety and efficacy of endoscopic thyroidectomy in the treatment of papillary thyroid carcinoma through clinical follow-up. Methods: Patients who underwent total thyroidectomy and had a final pathologic diagnosis of papillary thyroid carcinoma at Department of Thyroid Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine between February 2013 and April 2014 were enrolled in this study; those who had family history of thyroid cancer or a history of radiation of the neck area were excluded...
February 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29390300/the-effect-of-no-drainage-in-patients-who-underwent-thyroidectomy-with-neck-dissection-a-systematic-review-and-meta-analysis
#6
REVIEW
Lei Li, Hengyu Chen, Huishan Tao, Weizhen Liu, Wenrong Li, Zhengwei Leng, Ende Zhao, Tao Huang
BACKGROUND: To evaluate the effect of no drainage in patients who underwent thyroidectomy and neck lymph node dissection. METHODS: We followed the methodological standard expected by Cochrane. We searched the following databases by March 23, 2017: PubMed, The Cochrane Library, EMBASE via Ovid SP, and Medline via Ovid SP. Two reviewers screened the studies and extracted the data. Randomized controlled trials (RCTs) or nonrandomized interventional studies assessing the effect of no drainage following thyroidectomy with lymph node dissection were included...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29389043/postoperative-day-1-levels-of-parathyroid-as-predictor-of-occurrence-and-severity-of-hypocalcaemia-after-total-thyroidectomy
#7
Alexander D Karatzanis, Despo P Ierodiakonou, Emmanuel S Fountakis, Stylianos G Velegrakis, Maria V Doulaptsi, Emmanuel P Prokopakis, Vasiliki N Daraki, George A Velegrakis
BACKGROUND: Hypocalcaemia is a common and serious complication after thyroidectomy. The purpose of this study is to assess the effectiveness of first postoperative day parathyroid hormone (PTH) measurement in order to predict the presence and severity of postthyroidectomy hypocalcaemia. METHODS: One hundred consecutive cases undergoing total thyroidectomy in a tertiary referral center were prospectively assessed. Preoperative measurements of PTH were compared with postoperative levels in the first morning after surgery...
February 1, 2018: Head & Neck
https://www.readbyqxmd.com/read/29380231/riedel-s-thyroiditis-clinical-presentation-treatment-and-outcomes
#8
Henrik Falhammar, Carl Christofer Juhlin, Caroline Barner, Sergiu-Bogdan Catrina, Christos Karefylakis, Jan Calissendorff
BACKGROUND: Riedel´s thyroiditis (RT) is a rare inflammatory disease of the thyroid gland, causing compression and fibrosis of adjacent tissues. Typically the goiter is hard and firm. Hoarseness, dyspnea, and dysphagia may be present. METHODS: We retrospectively reviewed all patients known by us with RT in addition to all patients with appropriate ICD-10 codes evaluated at the Karolinska University Hospital 2003-2015. Clinical, biochemical, and histological data of patients with RT were recorded in detail...
January 29, 2018: Endocrine
https://www.readbyqxmd.com/read/29370884/risk-of-major-complications-following-thyroidectomy-and-parathyroidectomy-utility-of-the-nsqip-surgical-risk-calculator
#9
Joseph Margolick, Sam M Wiseman
BACKGROUND: The primary objective of this study was to determine rates of reoperation, ED visits, and hospital readmission after thyroid and parathyroid surgery at a tertiary hospital. A secondary objective was to determine if scores from the American College of Surgeons Surgical Risk Calculator (ACS SRC) predicted these events. METHODS: We retrospectively reviewed the records of patients undergoing parathyroid and thyroid surgery between 2011 and 2014. Patients who underwent an unplanned reoperation, returned to the ED, or were readmitted to hospital were evaluated using the ACS SRC...
January 16, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29369600/postoperative-hypoparathyroidism-in-patients-after-total-thyroidectomy-retrospective-analysis
#10
Magdalena Marcinkowska, Beata Sniecikowska, Arkadiusz Zygmunt, Jan Brzezinski, Marek Dedecjus, Andrzej Lewinski
OBJECTIVES: Hypoparathyroidism is the most frequent complication of thyroidectomy. The incidence rates of temporary and permanent postoperative hypoparathyroidism vary from 7 to more than 60% and from 0 to 9%, respectively. DESIGN: The aim of the study has been to evaluate the incidence of hypoparathyroidism and clinical manifestations of hypocalcaemia after total thyroidectomy, as well as assess factors that affect the frequency of the symptomatic hypocalcaemia, and benefits resulting from the measurement of parathyroid hormone (PTH) concentration on the first day after thyroidectomy...
December 3, 2017: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/29366481/discussion-margolick-j-wiseman-sm-risk-of-major-complications-following-thyroidectomy-and-parathyroidectomy-utility-of-the-national-surgical-quality-improvement-program-nsqip-surgical-risk-calculator
#11
https://www.readbyqxmd.com/read/29360235/obviating-the-need-for-sternotomy-safety-and-effectiveness-of-microdebrider-use-for-retrosternal-goiter
#12
Elad Dagan, Stephen Kleid
BACKGROUND: Most retrosternal goiter surgical removal can be performed via a transcervical approach. However, it is often a challenging procedure, which might include sternotomy. METHODS: We describe a surgical technique using a microdebrider for intracapsular volume reduction that precedes an extracapsular thyroidectomy, thereby avoiding the need for sternotomy, with decreased morbidity and risk. The procedure is described in detail with 2 representative cases and a summary of our experience in 26 cases...
January 23, 2018: Head & Neck
https://www.readbyqxmd.com/read/29346027/postsurgical-outcomes-and-surgical-completeness-of-robotic-thyroid-surgery-a-single-surgeon-s-experience-on-700-cases
#13
Eon-Bin Kim, Jae Won Cho, Yu-Mi Lee, Tae-Yon Sung, Jong Ho Yoon, Ki-Wook Chung, Suck Joon Hong
BACKGROUND: Advanced technology and understanding of robotic surgical system have rendered robotic thyroid surgery more expanding. The aim of this study was to identify the periodic changes in postsurgical outcomes of robotic thyroid surgery performed by a single surgeon. METHODS: We conducted a retrospective review of 700 robotic thyroid surgery cases using gasless trans-axillary approach. RESULTS: All patients underwent successful operations without conversion to open surgery, and were mostly younger than 45 years, female, less-extended thyroid surgery and lymph node dissection, and thyroid cancer...
January 18, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29345225/indications-for-the-surgical-management-of-benign-goiter-in-adults
#14
Detlef K Bartsch, Markus Luster, Heinz J Buhr, Dietmar Lorenz, Christoph-Thomas Germer, Peter E Goretzki
BACKGROUND: Thyroidectomy is still three to six times more common in Germany than in the USA, Great Britain, and the Scandinavian countries. Thus, the question is often asked whether thyroidectomy in Germany is being performed for the correct indications. METHODS: This review is based on studies and guidelines containing information on the indications for surgery in benign goiter and Graves' disease; these publications were retrieved by a systematic literature search in the Medline and Cochrane Library databases (1990-2016)...
January 8, 2018: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29341155/long-term-outcome-of-prophylactic-thyroidectomy-in-children-carrying-ret-germline-mutations
#15
A Machens, M Elwerr, K Lorenz, F Weber, H Dralle
BACKGROUND: A comprehensive assessment has not been undertaken of long-term outcomes in children carrying germline RET mutations and undergoing prophylactic thyroidectomy with the aim of preventing medullary thyroid cancer (MTC). METHODS: A retrospective outcome study (1994-2017) of prophylactic thyroidectomy in children, with and without central node dissection, was performed at a tertiary surgical centre. RESULTS: Some 167 children underwent prophylactic thyroidectomy, 109 without and 58 with concomitant central node dissection...
January 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29340816/expanding-indications-of-robotic-thyroidectomy
#16
Se Hyun Paek, Kyung Ho Kang, Sung Jun Park
BACKGROUND: Robotic thyroidectomy has many advantages with comparable oncologic safety over conventional open surgery in low-risk differentiated thyroid cancer cases. However, there have been few reports on the outcomes of patients who have been treated with robotic thyroidectomy for more advanced thyroid cancer. The aim of this study was to investigate the validity of expanding indications of robotic thyroidectomy for more advanced thyroid cancer. METHODS: The data of 80 patients with thyroid cancer who underwent robotic total thyroidectomy between January 2013 and December 2014 performed by a single surgeon at Chung-Ang University Hospital were retrospectively reviewed...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29336779/prophylactic-thyroidectomies-in-men2-syndrome-management-and-outcomes
#17
Virginie Bussières, Shreyas Roy, Johnny Deladoey, Élisabeth Rousseau, Dickens St-Vil, Nelson Piché
AIM OF THE STUDY: The aim of the study was to evaluate the outcomes of prophylactic thyroidectomies performed in an academic setting in the context of multiple endocrine neoplasia type 2 (MEN2) syndrome. METHODS: A chart review of patients <18years old who underwent prophylactic thyroidectomy for a MEN2 syndrome at a children's hospital between 2006 and 2015 was performed. MAIN RESULTS: The study included 21 patients (57% female) with a mean age of 6...
November 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29330874/safety-of-high-current-stimulation-for-intermittent-intraoperative-neural-monitoring-in-thyroid-surgery-a-porcine-model
#18
I-Cheng Lu, Pi-Ying Chang, Gregory W Randolph, Hsiu-Ya Chen, Kuang-Yi Tseng, Yi-Chu Lin, Feng-Yu Chiang, Che-Wei Wu
OBJECTIVES: During monitored thyroidectomy, displacement of the recurrent laryngeal nerve (RLN) or vagus nerve (VN) in some complicated cases can increase the risk of injury. Although increasing the stimulus current can facilitate nerve mapping and localization, the safety of a high-current stimulus remains unknown. Therefore, this study evaluated the safety of a high-current stimulus in a porcine model. METHODS: Short-duration (1 minute), high-current (3, 5, 10, 15, 20, 25, and 30 mA at 4Hz) stimulus pulses were repeatedly applied to the RLN or VN in six anesthetized piglets...
January 13, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29322025/short-and-long-term-impact-of-parathyroid-autotransplantation-on-parathyroid-function-after-total-thyroidectomy
#19
REVIEW
Gabrielle Hicks, Robert George, Mark Sywak
The most common complication of total thyroidectomy is parathyroid insufficiency. Acute, transient, post-operative hypoparathyroidism increases length of hospitalization, morbidity and cost associated with total thyroidectomy. While permanent hypoparathyroidism poses a significant medical burden with lifetime medication, regular follow up and considerable disease burden related to chronic renal failure and other sequelae. Parathyroid autotransplantation has been demonstrated to result in biochemically functional grafts, leading to the procedures' common use during total thyroidectomy...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29322024/hypocalcaemia-and-permanent-hypoparathyroidism-after-total-bilateral-thyroidectomy-in-the-baets-registry
#20
REVIEW
David R Chadwick
The UK Registry of Endocrine and Thyroid Surgeons (UKRETS) has been operated by the British Association of Endocrine and Thyroid Surgeons (BAETS) and Dendrite Clinical Systems Ltd. in a web-based electronic format since 2004. Data on over 90,000 endocrine procedures have been collected to date. Analysis of those cases undergoing bilateral thyroid resections in the interval July 2010 to June 2015 demonstrates that hypocalcaemia remains the commonest complication of thyroid surgery. After first-time total thyroidectomy, 23...
December 2017: Gland Surgery
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