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Thyroidectomy complications

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https://www.readbyqxmd.com/read/28646422/how-to-avoid-and-to-manage-post-operative-complications-in-thyroid-surgery
#1
REVIEW
Matteo Angelo Cannizzaro, Salvatore Lo Bianco, Maria Carolina Picardo, Daniele Provenzano, Antonino Buffone
Complications of thyroidectomy are hypoparathyroidism, recurrent laryngeal nerve palsy, and hemorrhage. These complications have a low incidence. Hypoparathyroidism is the most frequent complication of total thyroidectomy. Its incidence varies between 0.5 and 65%. This complication is also visible after reoperation for recurrent disease and in patients previously treated with radioiodine. Damage to the recurrent laryngeal nerve can be temporary or permanent, unilateral or bilateral. The bilateral lesion, associated with severe episodes of breathlessness, is a rare complication (0...
June 23, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28616866/vocal-palsy-increases-the-risk-of-lower-respiratory-tract-infection-in-low-risk-low-morbidity-patients-undergoing-thyroidectomy-for-benign-disease-a-big-data-analysis
#2
S A R Nouraei, J Allen, H Kaddour, S E Middleton, P Aylin, A Darzi, N S Tolley
OBJECTIVES: Thyroidectomy is the commonest and most rapidly-growing operation which places normally-functioning laryngeal nerves at risk of injury. Laryngeal palsy is a major risk-factor for dysphonia, dysphagia, and less commonly, airway obstruction. We investigated the association between post-thyroidectomy vocal palsy and long-term risks of pneumonia and laryngeal failure. DESIGN: An N=near-all analysis of the English administrative dataset using a previously-validated informatics algorithm to identify young and otherwise low-risk patients undergoing thyroidectomy for benign disease...
June 14, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28612896/total-thyroidectomy-the-first-the-best-the-recurrent-goiter-issue
#3
A Cappellani, A Zanghì, F Cardì, A Cavallaro, G Piccolo, S Palmucci, G Fuccio Sanzà, M Di Vita
BACKGROUND: Redo surgery for recurrent goiter is still now, even in experienced hands, followed by higher morbidity than primary total thyroidectomy. Suppressive Levothyroxine therapy failed to improve the recurrence rate, while inducing a subclinical hyperthyroidism. Aim of this study is to verify morbidity after total thyroidectomy for benign thyroid diseases, both primary and after recurrence. MATERIALS AND METHODS: A series of 20 cases of total thyroidectomy for recurrent benign diseases (RG), performed between January 2001 and December 2013 was compared with 225 cases of primary total thyroidectomy (PT) ...
May 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28608527/perfect-storm-therapeutic-plasma-exchange-for-a-patient-with-thyroid-storm
#4
Andrea M McGonigle, Aaron A R Tobian, Jennifer L Zink, Karen E King
Thyroid storm is a potentially lethal complication of hyperthyroidism with increased thyroid hormones and exaggerated symptoms of thyrotoxicosis. First-line therapy includes methimazole (MMI) or propylthiouracil (PTU) to block production of thyroid hormones as a bridge toward definitive surgical treatment. Untreated thyroid storm has a mortality rate of up to 30%; this is particularly alarming when patients cannot tolerate or fail pharmacotherapy, especially if they cannot undergo thyroidectomy. Therapeutic plasma exchange (TPE) is an ASFA category III indication for thyroid storm, meaning the optimum role of this therapy is not established, and there are a limited number of cases in the literature...
June 13, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28602544/morbidity-of-total-thyroidectomy-for-substernal-goiter-a-series-of-70-patients
#5
N Tabchouri, Z Anil, F Marques, N Michot, P Dumont, V Arnault, L De Calan
Total thyroidectomy for substernal goiter occasionally requires a sternotomy associated with a cervical incision. We sought to analyze the postoperative complications of thyroidectomy for substernal goiters in our center and more precisely the complications related to the sternotomy. All patients who underwent total thyroidectomy for substernal goiter in our center between 2007 and 2016 were reviewed retrospectively. Patients with combined cervical incision and sternotomy (ST group, n=16) were compared to those with cervical incision alone (CT group, n=54), with regard to postoperative complications...
June 8, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28599790/long-term-outcomes-of-central-neck-dissection-for-cn0-papillary-thyroid-carcinoma
#6
Davide Giordano, Andrea Frasoldati, Enrico Gabrielli, Carmine Pernice, Michele Zini, Andrea Castellucci, Simonetta Piana, Alessia Ciarrocchi, Silvio Cavuto, Verter Barbieri
OBJECTIVE: The risk-benefit ratio of central neck dissection (CND) in patients affected by papillary thyroid carcinoma (PTC) without clinical or ultrasonographic (US) evidence of neck lymph node metastasis (cN0) is currently debated. The aim of this study was to evaluate long-term outcome of CND on locoregional recurrence, distant metastasis, survival, and postoperative complications in a large series of patients with cN0-PTC. STUDY DESIGN: Observational retrospective controlled study...
June 7, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28589182/recurrent-laryngeal-nerve-injury-and-hypoparathyroidism-rates-in-reoperative-thyroid-surgery
#7
Mohamed Benkhadoura, Salah Taktuk, Reem Alobedi
OBJECTIVE: Reoperative thyroid surgery is rare and has a high complication rate. This retrospective cohort study was performed to determine the recurrent laryngeal nerve injury and hypoparathyroidism rates after reoperative thyroid surgery in two university hospitals in Benghazi, Libya. MATERIAL AND METHODS: All consecutive patients who underwent reoperative thyroid surgery between January 2002 and July 2014 were included retrospectively. The cohort was divided according to whether the reoperation was in the previously operated lobe or both lobes (ipsilateral group), or only in the previously non-operated lobe (contralateral group)...
2017: Turk J Surg
https://www.readbyqxmd.com/read/28589093/successful-pretreatment-using-plasma-exchange-before-thyroidectomy-in-a-patient-with-amiodarone-induced-thyrotoxicosis
#8
Annelies Tonnelier, Jeroen de Filette, Ann De Becker, Sophie Deweer, Brigitte Velkeniers
INTRODUCTION: Amiodarone, used for the management of tachyarrhythmias, is associated with both hypothyroidism and thyrotoxicosis. Total thyroidectomy is an effective procedure for promptly reducing circulating thyroid hormone levels. It has been proposed in patients who have severe amiodarone-induced thyrotoxicosis (AIT) or are refractory to medical therapy, or when such therapy is contraindicated. Therapeutic plasma exchange (TPE) may be considered as a pretreatment for restoring a euthyroid state preoperatively, thereby reducing a patient's symptoms and the potential perioperative risk associated with thyrotoxicosis...
April 2017: European Thyroid Journal
https://www.readbyqxmd.com/read/28580080/postoperative-nausea-and-vomiting-after-thyroidectomy-a-comparison-between-dexmedetomidine-and-remifentanil-as-part-of-balanced-anesthesia
#9
Eun Kyung Choi, Yijun Seo, Dong Gun Lim, Sungsik Park
BACKGROUND: Postoperative nausea and vomiting (PONV) is the major complication related to general anesthesia, occurring in 60-80% of patients after thyroidectomy. The objective of this study was to compare the effects of an intraoperative dexmedetomidine infusion with remifentanil, as anesthetic adjuvants of balanced anesthesia, on PONV in patients undergoing thyroidectomy. METHODS: Eighty patients scheduled for thyroidectomy were randomized into the following two groups: 1) The dexmedetomidine group (Group D), who received an initial loading dose of dexmedetomidine (1 µg/kg over 10 min) during the induction of anesthesia, followed by a continuous infusion at a rate of 0...
June 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28573781/outpatient-thyroidectomy-is-safe-in-the-elderly-and-super-elderly
#10
Jamie Segel Grubey, Yazdan Raji, William S Duke, David J Terris
OBJECTIVES: 1) Determine the safety of outpatient thyroidectomy in the geriatric patient population. 2) Analyze the risk of postoperative complications from thyroid surgery in patients aged over 65 years (elderly) and aged over 80 years (super-elderly) undergoing ambulatory thyroidectomy compared to patients aged 21 through 40 years. STUDY DESIGN: A retrospective analysis of consecutive patients undergoing thyroidectomy between January 2008 and July 2015 at a tertiary academic institution...
June 2, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28540785/single-session-high-intensity-focussed-ablation-hifu-versus-open-cervical-hemithyroidectomy-for-benign-thyroid-nodule-analysis-on-early-efficacy-safety-and-voice-quality
#11
Brian H H Lang, Carlos K H Wong, Estella P M Ma
BACKGROUND: High intensity focussed ultrasound (HIFU) is a promising non-surgical treatment for symptomatic benign thyroid nodule. We aimed to compare early efficacy, safety and voice quality between HIFU ablation and open thyroidectomy. METHODS: Consecutive patients who underwent single-session HIFU ablation or a hemithyroidectomy for symptomatic benign thyroid nodule were included. The 6-month extent of nodule shrinkage, symptom improvement score, thyroid function, hospital stay and cost were compared between the two procedures...
March 24, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28537560/analysis-of-factors-affecting-the-development-of-hypocalcaemia-after-multinodular-goitre-surgery
#12
Piotr Papaj, Sławomir Kozieł, Sławomir Mrowiec
INTRODUCTION: Thyroidectomy is a common surgery performed especially in treatment of multinodular goitre. The most common post-thyroidectomy complication is a postoperative hypocalcaemia, and the percentage of postoperative hypoparathyroidism could reach even 50%. Tested group and methods: A forward-looking, randomized testing was done on a group of 113 women being subject to multinodular goitre surgery. In this article, we wish to present an analysis of the results obtained in the control group, focusing on the predicative factors which determine the development of postoperative hypocalcaemia...
April 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28537355/safety-and-cost-effectiveness-in-thyroidectomy-using-the-harmonic-scalpel-compared-to-traditional-hemostasis-a-controlled-clinical-assay
#13
Erich O P Basurto-Kuba, Maybelline Robles-Estrada, Luis Mauricio Hurtado-López, Edgar D Montes E Oca-Duran, Carlos Campos-Castillo, Felipe Rafael Zaldivar-Ramirez, Abraham Pulido-Cejudo
INTRODUCTION: The aim of this clinical control trial is to analyze the cost-effectiveness and to understand the efficacy of the HARMONIC FOCUS®+ (Ethicon Inc., Somerville, New Jersey) scalpel as the only system to cut and coagulate in thyroidectomy. MATERIALS AND METHODS: One hundered patients of the thyroid clinic of the Mexico City General Hospital were included. All patients underwent surgery and were divided into two randomized groups. In Group 1, the HARMONIC scalpel was the only device used for cut and coagulate (50 patients), and in Group 2 clamp, tie, and electrocautery (50 patients) were used...
May 24, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28523194/pneumomediastinum-and-bilateral-pneumothoraces-causing-respiratory-failure-after-thyroid-surgery
#14
Michael Koeppen, Benjamin Scott, Joseph Morabito, Matthew Fiegel, Tobias Eckle
We report the first case of severe respiratory failure after thyroid surgery requiring venovenous extracorporeal membrane oxygenation (vvECMO). The patient was a 41-year-old woman with metastatic thyroid cancer. She underwent thyroidectomy, including left lateral and bilateral central neck dissection. During surgery, the patient developed pneumomediastinum with bilateral pneumothoraces. Despite early treatment with bilateral chest tubes and no evidence of a tracheal perforation, the patient developed severe respiratory failure after extubation on the intensive care unit...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28506421/swallowing-disorders-after-thyroidectomy-what-we-know-and-where-we-are-a-systematic-review
#15
REVIEW
Gregorio Scerrino, Chiara Tudisca, Sebastiano Bonventre, Cristina Raspanti, Dario Picone, Calogero Porrello, Nunzia Cinzia Paladino, Federica Vernuccio, Francesco Cupido, Gianfranco Cocorullo, Giuseppe Lo Re, Gaspare Gulotta
INTRODUCTION: Dysphagia and hoarseness are possible complications that can be observed in patients undergoing thyroidectomy or other neck surgery procedures. These complaints are usually related to superior and inferior laryngeal nerves dysfunction, but these can appear even after uncomplicated surgical procedure. METHODS: We reviewed the current literature available on MEDLINE database, concerning the swallowing disorders appearing after the thyroidectomy. The articles included in the review reported pathophysiology and diagnostic concerns...
May 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28506418/timing-and-extension-of-lymphadenectomy-in-medullary-thyroid-carcinoma-a-case-series-from-a-single-institution
#16
Andrea Polistena, Alessandro Sanguinetti, Roberta Lucchini, Sergio Galasse, Massimo Monacelli, Stefano Avenia, Andrea Boccolini, Louis Banka Johnson, Nicola Avenia
BACKGROUND: Medullary thyroid carcinoma is an aggressive tumor and presents with significant morbidity and mortality and a high rate of lymph node metastases. The combination of total thyroidectomy and cervical lymphadenectomy is the essential treatment for those patients presenting with cervical lymph node metastases. MATERIALS AND METHODS: A retrospective analysis of 117 patients operated for medullary thyroid carcinoma over a period of 15 years at a single institution...
May 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28506413/nasotracheal-prolonged-safe-extubation-in-acute-respiratory-failure-post-thyroidectomy-an-efficacious-technique-to-avoid-tracheotomy-a-retrospective-analysis-of-a-large-case-series
#17
F Ferraro, C Gambardella, D Testa, L Santini, R Marfella, P Fusco, C P Lombardi, A Polistena, A Sanguinetti, N Avenia, G Conzo
BACKGROUND: Acute respiratory failure is a rare life threatening complication following thyroid surgery and its incidence is reported as high as 0.9%. Clinical presentation of severe acute respiratory failure is characterized by dyspnea, inspiratory airways distress, hypoxia and its standard current management is the orotracheal intubation and safe extubation. In case of persistent distress, tracheotomy is mandatory. The Authors, analysing a large acute respiratory failure clinical series, describe an innovative treatment of this severe condition: the nasotracheal prolonged safe extubation...
May 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28506412/rationality-in-prophylactic-central-neck-dissection-in-clinically-node-negative-cn0-papillary-thyroid-carcinoma-is-there-anything-more-to-say-a-decade-experience-in-a-single-center
#18
C Dobrinja, M Troian, T Cipolat Mis, G Rebez, S Bernardi, B Fabris, L Piscopello, P Makovac, F Di Gregorio, N de Manzini
AIM: Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy. Despite its extremely favorable prognosis, cervical lymph node metastases are a common feature of PTC and a known independent risk factor for local recurrence. However, the role of prophylactic central neck dissection (PCND) remains a matter of debate in patients with clinically node-negative (cN0) PTC. To better clarify the current role of PCND in the surgical treatment of PTC, evaluating advantages and disadvantages of PCND and outcome of cN0 PTC patients who have been treated with either total thyroidectomy alone or in combination with PCND...
May 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28506411/partial-thyroidectomy-for-papillary-thyroid-microcarcinoma-is-completion-total-thyroidectomy-indicated
#19
C Dobrinja, M Pastoricchio, M Troian, F Da Canal, S Bernardi, B Fabris, N de Manzini
AIM: Papillary thyroid microcarcinoma (PTMC) is increasing in incidence. Despite its excellent clinical outcomes, there is still debate regarding which surgical approach is more appropriate for PTMC, procedures including hemithyroidectomy (HT), total thyroidectomy (TT), and completion thyroidectomy (CT) after initial HT and histopathologic examination confirming a PTMC. Here we report our experience in the surgical management of PTMC. METHODS: We conducted a retrospective evaluation of all patients who received a postoperative diagnosis of PTMC between January 2001 and January 2016...
May 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28502882/single-incision-endoscopic-thyroidectomy-for-papillary-thyroid-cancer-a-pilot-study
#20
Jinbeom Cho, Yohan Park, Jongmin Baek, Kiyoung Sung
BACKGROUND: Recently, we have reported single incision endoscopic thyroidectomy using an axillary approach with gas inflation (SIET) in cases with benign thyroid tumors to reduce post-operative pain and invasiveness of the conventional endoscopic thyroidectomy. The aim of this study was to present our experiences with SIET for papillary thyroid cancer (PTC). METHODS: Patients who were diagnosed with histologically papillary thyroid carcinoma (≤1 cm) with single, unilateral, and intra-thyroidal lesion and without clinical lymph node metastasis were included...
July 2017: International Journal of Surgery
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