scholarly journals Endoscopic Total Thyroidectomy: Report of Two Cases

1970 ◽  
Vol 26 (1) ◽  
pp. 46-49
Author(s):  
M Mohibul Aziz ◽  
MA Wohab Khan ◽  
Shamin Islam
Keyword(s):  
Total Thyroidectomy ◽  
Key Words ◽  
Vocal Cord ◽  
Thyroid Surgery ◽  
Harmonic Scalpel ◽  
Endoscopic Thyroidectomy ◽  
Vocal Cord Palsy ◽  
Experienced Hand ◽  
Thyroid Swelling ◽  
Medical University

Two patients (one male and one female) recently under went total thyroidectomies using a standard laparoscope at the department of surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Three ports (one mid line and two laterals) were employed and a harmonic scalpel was used for the dissection. To the best of our knowledge, there was no report of endoscopic total thyroidectomy from Bangladesh. Both patients were fed on the first post operative day. They were discharged between the 3rd and 4th post operative days. There was no hypocalcaemia but one patient developed temporary unilateral vocal cord palsy. Endoscopic thyroidectomy appears to be a technically feasible patient friendly modality of treatment for the selected cases of thyroid swelling in an experienced hand with excellent out come. Key Words: Endoscopic; laparoscopic; thyroid surgery; total thyroidectomy. DOI: 10.3329/jbcps.v26i1.4233 J Bangladesh Coll Phys Surg 2008; 26: 46-49

Major post-operative complications of thyroid surgery: Preventable or not?

2009 ◽  
Vol 34 (3) ◽  
pp. 99-103 ◽  
Author(s):  
M.A. Majid ◽  
Md. Ibrahim Siddique
Keyword(s):  
Total Thyroidectomy ◽  
Vocal Cord ◽  
Thyroid Surgery ◽  
Multinodular Goiter ◽  
Vocal Cord Palsy ◽  
Subtotal Thyroidectomy ◽  
Permanent Hypoparathyroidism ◽  
Respiratory Obstruction ◽  
Operative Complications ◽  
Toxic Multinodular Goiter

Factors responsible for major complications following thyroid surgery in 598 patients were studied. Patients with non toxic multinodular goiter involving both lobes of thyroid constituted the maximum bulk subjected to thyroidectomy. The most frequent procedure was bilateral subtotal thyroidectomy. Reactionary hemorrhage occurred in 6 patients, all following bilateral procedures and among them 5 patients developed tension hematoma with respiratory obstruction despite the presence of a drain. Temporary vocal cord palsy was observed in 7 patients whereas one patient subjected to total thyroidectomy with neck dissection for papillary carcinoma of thyroid developed permanent right vocal cord palsy. Temporary parathyroid insufficiency was seen in 51 patients and one patient developed permanent hypoparathyroidism. Incidence of parathyroid insufficiency was higher in bilateral procedures as compared to unilateral ones. There was no operation related death in this series, but complications like hemorrhage, vocal cord palsy and parathyroid insufficiency following thyroid surgery are still a deep concern. Keywords: Complication; Post-operative; Thyroid surgeryOnline: 29-1-2009DOI: 10.3329/bmrcb.v34i3.1973     Bangladesh Med Res Counc Bull 2008; 34: 99-103. 

scholarly journals Intraoperative Neuromonitoring in Thyroid Surgery: An Efficient Tool to Avoid Bilateral Vocal Cord Palsy

2020 ◽  
pp. 014556132090632
Author(s):  
Kinyas Kartal ◽  
Nurcihan Aygun ◽  
Mustafa Fevzi Celayir ◽  
Evren Besler ◽  
Bulent Citgez ◽  
...  
Keyword(s):  
Vocal Cord ◽  
Thyroid Surgery ◽  
Health Care Professionals ◽  
Surgical Techniques ◽  
Vocal Cord Palsy ◽  
Intraoperative Neuromonitoring ◽  
Efficient Tool ◽  
Group 2 ◽  
Neural Monitoring ◽  
Group 1

Objectives: This study aimed to analyze the effects of intraoperative neuromonitoring (IONM) on the prevalence of vocal cord palsy (VCP) in thyroid surgery. Methods: Data from 493 patients (839 nerves at risk [NAR]) who underwent thyroid surgery between July 2014 and May 2016 were retrospectively evaluated. The patients were divided into 2 groups: Group 1 (G1) consisted of patients who underwent surgery without IONM, whereas group 2 (G2) consisted of patients who underwent surgery with IONM. The surgical techniques were identical, and experienced surgeons performed the procedures in both groups. Intraoperative neuromonitoring was performed in compliance with the International Neural Monitoring Guidelines. Results: In total, 211 patients (170 female, 41 male) with 360 NAR were included in G1, and 282 patients (220 female, 62 male) with 479 NAR were included in G2. The number of VCP per NAR in G1 and G2 was 33 (9.2%) and 27 (5.6%), respectively ( P = .005). The number of transient VCP per NAR in G1 and G2 was 27 (7.5%) and 23 (4.8%; P = .230), respectively. The number of permanent VCP per NAR in G1 and G2 was 6 (1.7%) and 4 (0.8%; P = .341), respectively. Bilateral VCP was detected in 4 (2.7%) patients in G1, whereas there was no patient with bilateral VCP in G2 ( P = .033). Conclusions: Intraoperative neuromonitoring may decrease the incidence of total VCP and prevent the development of bilateral VCP, which has unfavorable results for both patients and health-care professionals.

scholarly journals Single Surgeon Experience with 500 Cases of the Robotic Bilateral Axillary Breast Approach (BABA) for Thyroid Surgery Using the Da-Vinci Xi System

2021 ◽  
Vol 10 (18) ◽  
pp. 4048
Author(s):  
Yun-Suk Choi ◽  
Woo-Young Shin ◽  
Jin-Wook Yi
Keyword(s):  
Vocal Cord ◽  
Thyroid Surgery ◽  
Operation Time ◽  
Vocal Cord Palsy ◽  
Remote Access ◽  
Serum Thyroglobulin ◽  
Lymph Node Retrieval ◽  
Surgeon Experience ◽  
Thyroglobulin Level ◽  
Bilateral Axillary Breast Approach

Objectives: Robotic bilateral axillary breast approach (BABA) thyroid surgery began in 2008 and is now one of the most widely used remote-access thyroid surgeries worldwide. This study aimed to analyze the results of 500 robotic BABA thyroid surgeries performed in a single institution in Korea compared with open thyroid surgery. Methods: From December 2018 to March 2020, 502 robotic BABA thyroidectomies (RTs) and 531 conventional open thyroidectomies (OTs) were performed in our institution by a single endocrine surgeon. We retrospectively reviewed patient medical records and performed a comparative analysis of OT and RT. Results: The RT group was younger (43.41 ± 11.41 versus 54.28 ± 13.41 years, p < 0.001) and had a higher proportion of females (84.3% versus 69.3%, p < 0.001), a lower BMI (24.66 ± 3.97 versus 25.83 ± 4.07 kg/m2), a higher proportion of lobectomies (52.6% versus 45.2%) and a lower proportion of lateral neck dissections (3.4% versus 10.0%, p < 0.001). The RT group had a longer operation time (145.33 ± 40.80 versus 93.39 ± 43.55 min, p < 0.001) and higher surgical costs. Although the OT group had a larger tumor size and a higher proportion of extrathyroidal extension, the numbers of retrieved lymph nodes were not significantly different between the two groups. Additionally, there was no difference in the stimulated thyroglobulin level before radioactive iodine therapy (7.01 ± 35.73 versus 8.39 ± 58.77, p = 0.782). The rates of transient vocal cord palsy and transient hypoparathyroidism were significantly lower in the RT group, and those of scar-related complications were higher in the OT group. Conclusions: Robotic BABA thyroid surgery has advantages not only in better cosmetic outcomes but also in lower rates of vocal cord palsy and hypoparathyroidism, with comparable lymph node retrieval and serum thyroglobulin levels.

scholarly journals Comparison of Recurrent Laryngeal Nerve Identification Time in the Lower Central Triangle During Thyroid Surgery Using Neurophysiological Mapping and Monitoring

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 748
Author(s):  
Eunhye Lee ◽  
Keunchul Lee ◽  
Hyeongwon Yu ◽  
Sujin Kim ◽  
Youngjun Chai ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Thyroid Surgery ◽  
Vocal Cord Palsy ◽  
Laryngeal Nerve ◽  
Follicular Neoplasm ◽  
National University ◽  
Seoul National University ◽  
Definition Of ◽  
Intraoperative Nerve Monitoring

Background and Objectives: Preserving the recurrent laryngeal nerve (RLN) is important in thyroid surgery. However, no standardized surgical method for locating the RLN has been established. We defined a new anatomical definition termed “lower central triangle” (LCT) for consistent identification of RLN and used intraoperative nerve monitoring (IONM) to aid in identification and dissection of RLN. Materials and Methods: Patients undergone thyroidectomy were reviewed retrospectively in Seoul National University Bundang Hospital from January to September 2017. Patients with papillary thyroid carcinoma, follicular neoplasm, and Graves’ Disease were included while right side non-RLN in arteriosus lusoria, cancer invasion, pre-existing vocal cord palsy, or under the age of 18 were excluded. RLNs were tested with IONM within LCT consisting of the lower pole as the apex and the common carotid artery as the opposite side. The samples were divided into two groups, IONM and non-IONM. Results: Forty lobes in total were included, 22 in IONM group and 18 in non-IONM group. Groups were not significantly different in age, cancer proportion, and accompanying thyroiditis while sex and nodule size differed. RLN detection time was 10.43 sec shorter (p < 0.001), and confirmation time was 10.67 sec shorter (p = 0.09) in IONM group than in non-IONM group. Both right and left RLNs were located predominately in the middle of LCT. No transient or permanent vocal cord palsy occurred. Conclusions: While IONM is an appropriate aid for thyroidectomy, our approach using LCT to locate the RLN is a novel definition of anatomy that provides prompt identification of the RLN in thyroid surgery.

Transcutaneous Ultrasonography in Early Postoperative Diagnosis of Vocal Cord Palsy After Total Thyroidectomy

2016 ◽  
Vol 40 (3) ◽  
pp. 665-671 ◽  
Author(s):  
Frédéric Borel ◽  
Anne-Sophie Delemazure ◽  
Florent Espitalier ◽  
Andrew Spiers ◽  
Eric Mirallie ◽  
...  
Keyword(s):  
Total Thyroidectomy ◽  
Vocal Cord ◽  
Vocal Cord Palsy ◽  
Postoperative Diagnosis

scholarly journals Assessment of recurrent laryngeal nerve function during thyroid surgery

2014 ◽  
Vol 96 (2) ◽  
pp. 130-135 ◽  
Author(s):  
J Smith ◽  
J Douglas ◽  
B Smith ◽  
T Dougherty ◽  
C Ayshford
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Direct Laryngoscopy ◽  
Thyroid Surgery ◽  
Vocal Cord Palsy ◽  
Laryngeal Nerve ◽  
Laryngeal Function ◽  
Nerve Monitoring ◽  
Vocal Cord Function ◽  
Intraoperative Nerve Monitoring

Introduction There is disparity in the reported incidence of temporary and permanent recurrent laryngeal nerve (RLN) palsy following thyroidectomy. Much of the disparity is due to the method of assessing vocal cord function. We sought to identify the incidence and natural history of temporary and permanent vocal cord palsy following thyroid surgery. The authors wanted to establish whether intraoperative nerve monitoring and stimulation aids in prognosis when managing vocal cord palsy. Methods Prospective data on consecutive thyroid operations were collected. Intraoperative nerve monitoring and stimulation, using an endotracheal tube mounted device, was performed in all cases. Endoscopic examination of the larynx was performed on the first postoperative day and at three weeks. Results Data on 102 patients and 123 nerves were collated. Temporary and permanent RLN palsy rates were 6.1% and 1.7%. Most RLN palsies were identified on the first postoperative day with all recognised at the three-week review. No preoperative clinical risk factors were identified. Although dysphonia at the three-week follow-up visit was the only significant predictor of vocal cord palsy, only two-thirds of patients with cord palsies were dysphonic. Intraoperative nerve monitoring and stimulation did not predict outcome in terms of vocal cord function. Conclusions Temporary nerve palsy rates were consistent with other series where direct laryngoscopy is used to assess laryngeal function. Direct laryngoscopy is the only reliable measure of cord function, with intraoperative monitoring being neither a reliable predictor of cord function nor a predictor of eventual laryngeal function. The fact that all temporary palsies recovered within four months has implications for staged procedures.

Sign in / Sign up

Export Citation Format

Share Document