Reasons Associated with Total Thyroidectomy as Initial Surgical Management of an Indeterminate Thyroid Nodule

2018 ◽  
Vol 25 (5) ◽  
pp. 1410-1417 ◽  
Author(s):  
Trevor E. Angell ◽  
Chirag M. Vyas ◽  
Justine A. Barletta ◽  
Edmund S. Cibas ◽  
Nancy L. Cho ◽  
...  
1992 ◽  
Vol 102 (12) ◽  
pp. 1353-1356 ◽  
Author(s):  
Michael Bouvet ◽  
Jeffrey I. Feldman ◽  
Gordon N. Gill ◽  
Wolfgang H. Dillmann ◽  
Alan M. Nahum ◽  
...  

2020 ◽  
Vol 48 (1) ◽  
pp. 22
Author(s):  
MohammedA Hablus ◽  
HamedM.A Sallam ◽  
TahaA Ismail ◽  
MohamedM Elshikh

2017 ◽  
Vol 9 (3) ◽  
pp. 79-87 ◽  
Author(s):  
Marilla Dickfos ◽  
Robert Franz

ABSTRACT Introduction Amiodarone can be a life-saving medication; however, it can also cause amiodarone-induced thyrotoxicosis (AIT). Though rare, AIT is a complex and life-threatening side effect, which can cause significant cardiac dysfunction and lead to cardiac failure. Primary treatment is with thionamides, perchlorates, and steroids. However, a small subgroup does not respond and their cardiovascular function continues to deteriorate. This select group is referred for a semi-elective total thyroidectomy. Without surgical removal of their thyroid gland, these patients will continue to deteriorate, with a 30 to 50% mortality rate for those not operated on. Aim The aim of this case series was to assess for any indicators as to when these patients should be referred for total thyroidectomies and the efficacy of this method of treatment. Materials and methods A case series of patients with AIT treated with a total thyroidectomy from 1998 to 2015 was used to assess the efficacy of and indicators for surgery. Results Total thyroidectomy results in efficient and significant improvement in the patient's biochemistry and symptoms. The patient's symptoms and options for medical therapy have an influence on the duration of the trial of medical therapy. Conclusion Surgery is an effective and efficient treatment for AIT. However, there does not appear to be a specific indicator for when this treatment should be instigated. A case-by-case approach should be adopted when treating these complicated patients. Clinical significance Clinicians should see surgery as an effective and efficient treatment for AIT. The timing of surgery should be assessed on a case-by-case basis considering the patient's clinical status and therapeutic options and not as a last resort. How to cite this article Dickfos M, Franz R. Efficacy of the Surgical Management of Amiodarone-induced Thyrotoxicosis. World J Endoc Surg 2017;9(3):79-87.


Thyroid ◽  
2005 ◽  
Vol 15 (6) ◽  
pp. 569-574 ◽  
Author(s):  
Geeta Lal ◽  
Philip Ituarte ◽  
Electron Kebebew ◽  
Allan Siperstein ◽  
Quan-Yang Duh ◽  
...  

2019 ◽  
Vol 129 (4) ◽  
pp. 394-400 ◽  
Author(s):  
Narmien Haddad ◽  
Pratima Agarwal ◽  
Jessica R. Levi ◽  
Jeremiah C. Tracy ◽  
Lauren F. Tracy

Objective: To examine the clinical presentation, diagnostic evaluation, and management of Killian–Jamieson diverticula (KJD) through literature review. Methods: A comprehensive literature review was conducted through December 2018 using keywords Killian–Jamieson diverticula/diverticulum. Data extracted included clinical presentation, imaging characteristics, surgical management, and postoperative care. Sources: PubMed and Google Scholar. Results: Sixty-eight cases of KJD in 59 reports (29M:39F; median 58 years old) were identified for review. The most common presentation was dysphagia (n = 39), suspected thyroid nodule (n = 24) and globus (n = 14). The majority of KJD (n = 51) occur on the left, with rare reports of right side (n = 11) and bilateral (n = 5) presentation. Thirty-two cases describe surgical management: 22 utilizing a transcervical approach, with (n = 13) or without (n = 9) cricopharyngeal myotomy; and 10 reported endoscopic surgery. Diverticula managed transcervically averaged 3.8 cm in size in comparison to average 2.8 cm in the endoscopic group. Time to diet initiation after transcervical surgery averaged 4 days versus 2 days after endoscopic surgery. Complications were reported in 2/68 cases; both were diverticula recurrence after endoscopic surgery. Conclusion: Killian–Jamieson diverticula is a rare diagnosis that should be considered in the evaluation of dysphagia, globus, and also suspected thyroid nodule. When patient symptoms warrant intervention, a transcervical approach, with or without cricopharyngeal myotomy, is most commonly utilized. In recent years, an endoscopic approach has been presented as an alternative for smaller diverticula. Further understanding of the optimal treatment and postoperative management for KJD requires larger cohorts. Level of Evidence: 4


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