scholarly journals Comparison of the Complications of Subtotal, Near Total and Total Thyroidectomy in the Surgical Management of Multinodular Goitre

2005 ◽  
Vol 52 (2) ◽  
pp. 199-205 ◽  
Author(s):  
Serdar OZBAS ◽  
Savas KOCAK ◽  
Semih AYDINTUG ◽  
Atil CAKMAK ◽  
Mehmet Ali DEMIRKIRAN ◽  
...  
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.


2018 ◽  
Vol 25 (5) ◽  
pp. 1410-1417 ◽  
Author(s):  
Trevor E. Angell ◽  
Chirag M. Vyas ◽  
Justine A. Barletta ◽  
Edmund S. Cibas ◽  
Nancy L. Cho ◽  
...  

2018 ◽  
Vol 9 (2) ◽  
pp. 55-59
Author(s):  
Nadim Ahmed ◽  
Sami Ahmad ◽  
Farhad Uddin Ahmed ◽  
Muhammad Anwar Hossain ◽  
Krishna Pada Saha ◽  
...  

Background: Multinodular goitre is one of the most common endocrine surgical problems. Because controversy still continues to surround the use of total thyroidectomy for management of simple nodular goitre, the present study was conducted to compare the complications between total and subtotal thyroidectomy for management of simple multinodular goitre.Materials & methods: The experimental study was conducted in the department of Surgery and ENT, Rajshahi Medical College Hospital over a period of 2 years from July 2011 to June 2013. Of the total 83 simple multinodular goitre patients – 38 were assigned to total and 45 to subtotal thyroidectomy groups. Student’s t-test was done to analyze the means of quantitative variables & Chi-square (X2) and Fisher Exact test was applied to analyze categorical variables.Results: Most (88.9%) of patients in subtotal thyroidectomy (STT) group and 86.8% in total thyroidectomy (TT) group did not receive any blood transfusion during operation. Only 1(2.2%) patient in STT group experienced significant intraoperative haemorrhage. All patients were successfully operated. However, few patients of either group experienced some complications. Tetany was developed in 7.89% patients of TT and 4.44% patients of STT group. The other complication was recurrent laryngeal nerve (RLN) palsy (5.3% in TT and 2.2% in STT groups). No case of postoperative haemorrhage (haematoma) or wound infection was occured in either group. In TT group 5 (13.16%) patients and in STT group 4 (8.89%) patients developed different complications with no significant difference between the groups (p=0.533). The mean postoperative hospital stay was higher in TT group than In STT group (6.21 ± 0.99 vs. 5.96 ± 0.79 days), though the difference is not statistically significant (p= 0.206).Conclusions: The study shows that total thyroidectomy can be performed without increasing risk of complications and is a better alternative to subtotal thyroidectomy for the treatment of simple multinodular goitre.J Shaheed Suhrawardy Med Coll, December 2017, Vol.9(2); 55-59


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

2017 ◽  
Vol 131 (10) ◽  
pp. 925-929 ◽  
Author(s):  
M Erlem ◽  
N Klopp-Dutote ◽  
A Biet-Hornstein ◽  
V Strunski ◽  
C Page

AbstractObjective:To determine whether pre-operative serum 25-hydroxyvitamin D has an impact on post-operative parathyroid hormone and serum calcium levels in patients undergoing total thyroidectomy for benign goitre.Methods:This single-centre, retrospective study comprised 246 unselected surgical patients who had undergone total thyroidectomy for bilateral, benign, multinodular goitre. The correlation between pre-operative serum 25-hydroxyvitamin D and post-operative serum parathyroid hormone and serum calcium was studied to determine whether low pre-operative serum 25-hydroxyvitamin D was predictive of post-operative hypocalcaemia.Results:Seventy-nine patients (32 per cent) had post-operative hypocalcaemia. Eighteen patients (7.32 per cent) experienced unintentional parathyroidectomy (1 parathyroid gland in 15 patients, 2 parathyroid glands in 3 patients). In univariate analysis, pre-operative serum 25-hydroxyvitamin D was not correlated with post-operative serum calcium (p = 0.69) or post-operative serum parathyroid hormone (p = 0.5804). Furthermore, in multivariate analysis, which took into account unintentional parathyroidectomy, no correlation was found (p = 0.33). Bilateral unintentional parathyroidectomy was statistically associated with post-operative hypocalcaemia (p = 0.032).Conclusion:Pre-operative serum 25-hydroxyvitamin D did not appear to have any impact on post-operative serum calcium in patients undergoing total thyroidectomy for benign goitre.


2002 ◽  
Vol 168 (3) ◽  
pp. 196-196 ◽  
Author(s):  
M. Kaushal ◽  
G. Agarwal ◽  
S. K. Mishra

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