scholarly journals Minimally invasivethyroidectomy: A cosmetic alternative to standard thyroidectomy

2020 ◽  
Vol 10 (3) ◽  
pp. 65-68
Author(s):  
Tham X Ngo
Keyword(s):  
Patient Satisfaction ◽  
Clinical Results ◽  
Laryngeal Nerve ◽  
Papillary Thyroid ◽  
Minimally Invasive Thyroidectomy ◽  
Safe Alternative ◽  
Nodular Goitre ◽  
Open Thyroidectomy ◽  
Experienced Surgeon ◽  
Nerve Paresis

Background: We report on minimally invasive thyroidectomy (MIT) through a 2–4cm incision hypothesize similar clinical results to standard open thyroidectomy. Methods: Between January 2019 and March 2020, 61 MIT were evaluated for clinical outcomes, and patient satisfaction on a 1–10 scale. Results: The 61 study patients underwent MIT procedure. The final diagnoses were benign nodular goitre (63%), and papillary thyroid carcinoma (37%). Five patients had temporary recurrent laryngeal nerve paresis and four patients had temporary hypocalcemia. Conclusion: In selected patients, MIT through a 1,5–3cm incision assistance is a safe alternative to standard open thyroidectomy in the hands of an experienced surgeon. The clinical results are equivalent and patient satisfaction is significantly improved.

scholarly journals Comparison of Conventional Open Thyroidectomy and Endoscopic Thyroidectomy via Breast Approach for Papillary Thyroid Carcinoma

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Zhuo Tan ◽  
JiaLei Gu ◽  
QianBo Han ◽  
WenDong Wang ◽  
KeJing Wang ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Endoscopic Thyroidectomy ◽  
Patient Characteristics ◽  
Central Compartment ◽  
Clinical Results ◽  
Open Group ◽  
Papillary Thyroid ◽  
Open Thyroidectomy ◽  
Significant Difference

Purpose. The aim of this study was to evaluate the feasibility of endoscopic thyroidectomy via breast approach for papillary thyroid carcinoma (PTC).Methods. Between March 2008 and March 2013, 34 patients with PTC received endoscopic thyroidectomy (endo group) and 30 patients received conventional open thyroidectomy (open group). Patients in two groups underwent ipsilateral central compartment node dissection. The two groups were compared in terms of patient characteristics, perioperative clinical results, and postoperative complication.Results. The rates of lymph node metastasis in endo group and open group were 23.5% (8/34) and 13.3% (4/30), respectively, without statistically significant difference (P=0.351). The mean number of lymph nodes dissected was 2.4 ± 2.9 in endoscopic group and 2.2 ± 1.9 in open group (P=0.774). During the follow-up period, there was no recurrence or metastatic patients in two groups. All patients received the excellent cosmetic results in endo group, while 25 patients were satisfied with the cosmetic result and 5 were unsatisfied in the open group.Conclusions. The efficacy of endoscopic thyroidectomy via breast approach could be comparable to conventional open thyroidectomy in selected patients with PTC.

scholarly journals Is It the Surgeon, the Patient, or the Device? A Comprehensive Clinical and Radiological Evaluation of Factors Influencing Patient Satisfaction in 648 Total Knee Arthroplasties

2021 ◽  
Vol 10 (12) ◽  
pp. 2599
Author(s):  
Lorenzo Rissolio ◽  
Luigi Sabatini ◽  
Salvatore Risitano ◽  
Alessandro Bistolfi ◽  
Umberto Galluzzo ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Female Gender ◽  
Womac Score ◽  
Clinical Results ◽  
Positive Outcome ◽  
High Expectations ◽  
Surgeon Experience ◽  
Total Knee ◽  
Determinants Of Satisfaction ◽  
Final Alignment

Total knee arthroplasty (TKA) is a successful and safe surgical procedure for treating osteoarthritic knees, but despite the overall good results, some patients remain dissatisfied. The aim of this study is to evaluate the influence of patient-related and surgery-related variables in a consecutive group of patients that underwent TKA. Individuals (n = 648) who had TKA performed between 01 January 2013 and 31 December 2017 were enrolled in the study. Postoperative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS) and Forgotten Joint score (FJS-12) were collected at a mean follow-up of 4.79 years. Patient satisfaction was assessed with a questionnaire. Determinants of satisfaction (age, sex, smoking, presence of diabetes or cardiovascular disease, pain in other joints, preoperative arthritic stage) and components of satisfaction (slope variation, mechanical axis variation, outlier final alignment, surgeon experience) were examined to identify which variables correlated with positive outcome. Correlations with septic and mechanicals failures were also evaluated. Thirteen percent of patients were unsatisfied, despite good results in KOOS, WOMAC and FJS-12 tests. Female gender, low Kellgren–Lawrence grade and the presence of back pain and pain in other joints were factors associated with poor clinical results. Poorer clinical results were also reported in younger patients. Infection rate was correlated with active smoking and mechanical failure with an outlier final alignment. Comorbidities, smoking habits and high expectations have a big influence on TKA results and on final satisfaction after surgery.

P-207 Recurrent Laryngeal Nerve Invasion as an Independent Determinant of Complications and Outcome in Papillary Thyroid Cancer

Oral Oncology ◽  
2021 ◽  
Vol 118 ◽  
pp. 5
Author(s):  
Chiu Ho Quentin Mak ◽  
Chrysostomos Tornari ◽  
Noah Evans Harding ◽  
Daria Andreeva ◽  
Iain James Nixon ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Recurrent Laryngeal Nerve ◽  
Papillary Thyroid Cancer ◽  
Laryngeal Nerve ◽  
Papillary Thyroid ◽  
Nerve Invasion ◽  
Independent Determinant

scholarly journals 984 Changing the Management of Epistaxis in the Covid-19 Era

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
B Kerr ◽  
J Dalton ◽  
R Stewart ◽  
R Stewart ◽  
D McGahey
Keyword(s):  
Patient Satisfaction ◽  
Severe Pain ◽  
Community Hospital ◽  
Phone Call ◽  
Medical Assistance ◽  
Safe Alternative ◽  
Droplet Concentration ◽  
Nasal Secretions ◽  
Bed Days

Abstract Aim Epistaxis in the Covid pandemic is a concerning problem facing otolaryngologists due to high droplet concentration and increased virulence in nasal secretions. Furthermore, safe ambulation of patients reduces Covid exposure and preserves essential resources. This study assessed the implementation of ENT UK recommended altered epistaxis management during the Covid pandemic. Method Patients presenting to a medium-sized community hospital with unrelenting epistaxis had a rapid rhino (RR) inserted. Able patients were ambulated and given an appointment for RR removal. Previously all patients were admitted. A comparative retrospective analysis of patients referred with epistaxis was conducted using electronic care records from March – August 2019 versus the same period in 2020. Follow-up phone-call was also employed. Admissions, bed days, RR complications and patient satisfaction was assessed. Data was analysed student t-tests. Results A significant reduction in admissions (n = 91; P < 0.001) and bed days (n = 104; P < 0.001) was observed. Only 2 out of the 68 patients ambulated required medical assistance prior to their scheduled appointment (3%; P < 0.001). The majority of patients were satisfied (91%) and reported no bleeding (94%). No RR dislodgement occurred (0%) and most patients were pleased to avoid admission (92%). 70% of patients reported severe pain following RR insertion. Conclusions Ambulation of patients presenting to ED with unrelenting epistaxis managed with RR insertion is a safe alternative to previous practice with few complications. Furthermore, patients are largely satisfied although reported severe pain post RR insertion needs addressed. Finally, this altered management reduces contact and preserves resources as our hospitals face overwhelming pressures.

scholarly journals Predictive factors and prognosis for recurrent laryngeal nerve invasion in papillary thyroid carcinoma

2017 ◽  
Vol Volume 10 ◽  
pp. 4485-4491 ◽  
Author(s):  
Wenjie Chen ◽  
Jianyong Lei ◽  
Jiaying You ◽  
Yali Lei ◽  
Zhihui Li ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Recurrent Laryngeal Nerve ◽  
Predictive Factors ◽  
Laryngeal Nerve ◽  
Papillary Thyroid ◽  
Nerve Invasion

HEALTH-RELATED QUALITY OF LIFE IN A PATIENT FOLLOWING ANEURYSMOTOMY OF RARE MEGA-GIANT ANEURYSM OF THE COMMON CAROTID ARTERY

2020 ◽  
Vol 18 (4) ◽  
pp. 411-423
Author(s):  
Maria Pąchalska ◽  
Mariusz Trystuła
Keyword(s):  
Quality Of Life ◽  
Carotid Artery ◽  
Short Form ◽  
Laryngeal Nerve ◽  
Cerebral Protection ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Nerve Paresis

In the subject literature there are only a few articles devoted to the Health-Related Quality of Life (HRQoL) of patients with large ex- tracranial aneurysms of the carotid artery segment. There are no reports on the quality of life of patients with rare Mega-Giant Carotid Artery Aneurysms (MGCAA) manifesting themselves as chronically large and growing neck tumors. The aim of the research was an evaluation of the health related quality of life (HRQL) of a patient following aneurysmotomy of Mega-Giant Carotid Artery Aneurysms (MGCAA). An 82-year-old patient was referred to the Department of Vascular Surgery at the John Paul II Hospital in Krakow, due to the presence of a megagiant, painful tumor covering the entire left side of the neck. A physical examination and angio-CT confirmed the pres- ence of a pulsating tumor, which extended vertically from the level of the angle of the mandible to the clavicle, and horizontally from the trachea to the cervical spine. An aneurysmotomy and recon- struction of LICA with cerebral protection using a shunt catheter was performed. The patient was awakened from anesthesia and extubated shortly after the procedure, without any Central Nervous System neurological defects. The surgery was complicated by left recurrent laryngeal nerve paresis and aphonia without dyspnoea, which was only partially resolved around 3 months after the oper- ation itself. The postoperative period was uncomplicated. Health related Quality of Life (HRQoL) was studied using the 36-Item Short Form Health Survey (SF-36) to study both the clinical symp-toms and how these symptoms would be reduced in a year follow up after the aneurysmotomy. Despite the increasing availability of endovascular options and techniques, open surgical repair of ICA aneurysms, especially Mega- Giant Carotid Artery Aneurysms (MGCAA), using cerebral protection (shunts), remains a basic option, providing an opportunity to avoid major intraoperative and postoperative complications. The aneurysmotomy, despite laryngeal nerve paresis and aphonia without dyspnoea, improves the patient’s health-related quality of life.

Thyroidectomy: Technique, Tips, and Troubleshooting

2018 ◽  
Author(s):  
Lindsay EY Kuo ◽  
Matthew A. Nehs
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Superior Laryngeal Nerve ◽  
Recurrent Laryngeal Nerve Injury ◽  
Laryngeal Nerve ◽  
Remote Access ◽  
Postoperative Hypocalcemia ◽  
Minimally Invasive Thyroidectomy ◽  
Perioperative Morbidity ◽  
Postoperative Hematoma ◽  
Thyroid Lobectomy

Historically, thyroidectomy was associated with a high mortality rate, now understood to likely be secondary to postoperative hypocalcemia. In the modern age, perioperative morbidity and mortality rates are extremely low, although some complications, such as recurrent laryngeal nerve injury, can have significant consequences. Understanding the safe approach to total thyroidectomy and thyroid lobectomy is key to minimizing operative morbidity. In particular, the capsular dissection technique facilitates identification and preservation of the recurrent laryngeal nerve and parathyroid glands. The postoperative care of the patient, including diagnosis and management of the more common complications such as hematoma or hypocalcemia, is crucial to optimize patient outcomes. Although novel thyroidectomy techniques have been developed to avoid or minimize the traditional neck incision, these approaches have not become widely used. This review contains 9 figures, 1 table, and 29 references.  Key Words: capsular dissection, external branch of the superior laryngeal nerve, intraoperative nerve monitoring, minimally invasive thyroidectomy, postoperative hematoma, postoperative hoarseness, postoperative hypocalcemia, recurrent laryngeal nerve, remote access thyroidectomy

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