scholarly journals The impact of thyroiditis on morbidity and safety in patients undergoing total thyroidectomy

2018 ◽  
Vol 22 (4) ◽  
pp. 494 ◽  
Author(s):  
Sankaran Muthukumar ◽  
Krishnan Ravikumar ◽  
Dhalapathy Sadacharan ◽  
Umadevi Suresh ◽  
Thalavai Sundarram ◽  
...  
Keyword(s):  
Total Thyroidectomy ◽  
The Impact

scholarly journals The impact of postoperative percent change of parathormone level from baseline value on the rate of hypocalcemia after total thyroidectomy

2017 ◽  
Author(s):  
Ismail Cem Sormaz ◽  
Ahmet Yalin Iscan ◽  
Ilker Ozgur ◽  
Seyma Karakus ◽  
Fatih Tunca ◽  
...  
Keyword(s):  
Total Thyroidectomy ◽  
Albumin Concentration ◽  
Postoperative Hypocalcemia ◽  
Percent Change ◽  
Number Of Patients ◽  
Increased Risk ◽  
Symptomatic Hypocalcemia ◽  
Postoperative Serum ◽  
Group 2 ◽  
The Impact

Background: To investigate the impact of the percent change of postoperative parathormone (PoPTH) level from baseline value (∆PTH) on the rate of hypocalcemia after total thyroidectomy. Methods: Assays of serum PTH and calcium (Ca) were performed preoperatively and at 24 hours postoperatively in 222 consecutive patients who underwent total thyroidectomy. Postoperative hypocalcemia was defined as serum calcium level corrected for albumin concentration (cCa) <8.5mg/dl. Patients with postoperative hypocalcemia were classified as group1 (n=100) and those with normal Ca levels as group 2 (n=122). The PoPTH levels and ∆PTH were compared between the two groups. ROC analysis was performed to determine the cut off values for PoPTH and ∆PTH. Results: The mean PoPTH level was significantly lower in group 1 compared to group 2 (18.6±15.3 pg/ml vs 32.3±15.6 pg/ml, respectively; P<0.0001). PoPTH values were within normal range in 54% of the patients with hypocalcemia and 35% of those with symptomatic hypocalcemia. PoPTH <28pg/ml or ∆PTH >45 were significantly associated with increased risk of post-thyroidectomy hypocalcemia (P=0.0001). A ∆PTH >70% ,PoPTH ≤ 15.5pg/ml and postoperative serum cCa concentrations<8.0mg/dl significantly predicted symptomatic hypocalcemia(P=0.009;P=0.006;andP=0.0001;respevtively).The sensitivities of ∆PTH,PoPTH level and postoperative serum cCa concentration to predict symptomatic hypocalcemia were 67%,64% and100, respectively. Conclusion: Although, PTH decline significantly correlate with symptomatic hypocalcemia, a considerable number of patients may experience hypocalcemic symptoms in spite of normal PoPTH levels. Analysis of serum Ca concentrations at 24 hours postoperatively help to achieve a more precise prediction of patients who bear a high risk for developing hypocalcemic symptoms.

scholarly journals Impact of total thyroidectomy on quality of life at 6 months: the prospective ThyrQoL multicentre trial

2020 ◽  
Vol 182 (2) ◽  
pp. 195-205 ◽  
Author(s):  
E Mirallié ◽  
F Borel ◽  
C Tresallet ◽  
A Hamy ◽  
M Mathonnet ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Total Thyroidectomy ◽  
Short Form ◽  
Multivariable Analysis ◽  
Vocal Cord Palsy ◽  
Multicenter Trial ◽  
Significant Impairment ◽  
The Impact ◽  
Benign Thyroid

Objective This study is to determine the impact of complications after total thyroidectomy on health-related quality of life (HR-QoL) and to identify significant predictive factors of HR-QoL changes. HR-QoL is usually impaired in patients with thyroid diseases compared to the general population. Thyroidectomy is largely performed in the case of benign thyroid benign and can be associated with long-term complications (vocal cord palsy, hypoparathyroidism). Design The prospective ThyrQoL multicenter trial (NCT02167529) included 800 patients who underwent total thyroidectomy for benign or malignant non-extensive disease in seven French referral hospitals between 2014 and 2016. Methods HR-QoL was assessed using the MOS 36-item short form health survey (SF-36) self-questionnaire with a 6-month follow-up. Results We observed a significant improvement of HR-QoL 6 months after surgery (P < 0.0001). Postoperative complications were associated with a non-significant impairment of HR-QoL. In multivariable analysis, Graves’ disease was associated with a significant improvement of HR-QoL (OR = 2.39 [1.49; 3.84]) and thyroid malignant disease with an impairment of HR-QoL (OR = 1.44 [0.99; 2.08]) after thyroidectomy. Conclusion We observed a significant improvement of HR-QoL 6 months after total thyroid surgery for benign thyroid disease.

scholarly journals 288 Impact of Trainee Surgeons Performing Thyroid Procedure on Patient Safety

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Nessa ◽  
S Aspinall
Keyword(s):  
Patient Safety ◽  
Total Thyroidectomy ◽  
Predictive Factors ◽  
Postoperative Bleeding ◽  
Multivariable Analysis ◽  
Vocal Cord Palsy ◽  
Primary Operator ◽  
Nodal Dissection ◽  
Multivariable Analyses ◽  
The Impact

Abstract Introduction Impact of trainee surgeons performing thyroid procedure on patient safety Aim The primary aim was to evaluate the impact of trainee as the principal operator on patient safety in thyroid surgery. Method The data was extracted from a single consultant’s data from 2009 to 2020 in the British Association of Endocrine and Thyroid Surgeons (BAETS) National audit. Multivariable analysis of predictive factors (including trainee primary operator) for temporary and permanent hypocalcaemia was performed. Results There were 507 thyroid cases. After excluding cases with missing data in variables analysed 378 (74.5%) cases were analysed. Vocal cord palsy occurred in 5/378 (1.3%), postoperative bleeding 3/378 (0.8%), temporary hypocalcaemia 68/378 (18.0%) and permanent hypocalcaemia 20/378 (5.3%). Predictive factors analysed included hyperthyroidism 117/378 (31%), retrosternal goitre 33/378 (8%), reoperation, 43/378 (11%), total thyroidectomy 184/378 (49%), nodal dissection 21/378 (6%) and trainee principal operator 15/378 (4%). Multivariable analyses of temporary and permanent hypocalcaemia found only two variables significantly affected incidence of temporary hypocalcaemia were total thyroidectomy (OR 7.82, 95% CI 3.41-17.92, p &lt; 0.001) and nodal dissection (OR 3.53, 95% CI 1.20-10.38, p = 0.02), and for permanent hypocalcaemia these were reoperation (OR 5.05, 95% CI 1.09-23.25, p = 0.04) and total thyroidectomy (OR 5.76, 95% CI 1.35-24.54, p = 0.018). Conclusions There was no evidence that trainee principal operator adversely affected the outcome of thyroidectomy; it is worth noting that only 4% of operations were done by trainees and so this study would support trainees undertaking more thyroidectomies as principal surgeon.

scholarly journals Partial Cutting of Sternothyroid Muscle during Total Thyroidectomy: Impact on Postoperative Vocal Outcomes

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Hyoung Shin Lee ◽  
Sung Won Kim ◽  
Hyo Sang Park ◽  
Chan Woo Park ◽  
Ji Soo Kim ◽  
...  
Keyword(s):  
Total Thyroidectomy ◽  
Negative Impact ◽  
Central Neck Dissection ◽  
Maximum Frequency ◽  
Voice Analysis ◽  
Partial Cutting ◽  
Group A ◽  
Group B ◽  
The Impact ◽  
Superior Pole

Background. Cutting the sternothyroid (ST) muscle is a useful technique to expose the superior pole of thyroid gland during thyroidectomy. In this study, we evaluated the impact of partial cutting of the ST muscle on postoperative vocal outcomes after total thyroidectomy.Methods. A retrospective review of 57 patients who underwent total thyroidectomy with central neck dissection for micropapillary thyroid carcinoma was conducted. Group A (n=26) included those without cutting the ST muscle, while group B (n=31) included patients whose muscle was partially cut at the superior pole. All patients underwent voice analysis before the operation and 2 weeks and 1 month after the surgery, and the outcomes were compared between the two groups.Results. There were no differences between the two groups regarding the outcomes at each time of voice analysis. Group A showed a decrease of maximum frequency 2 weeks after surgery but showed no difference after 1 month. Group B showed a mild decrease in maximum frequency 2 weeks after surgery, but the difference was not significant.Conclusion. Partial cutting of ST muscle during thyroidectomy is useful to expose the superior pole without significant negative impact on postoperative outcomes of vocal analysis.

scholarly journals Impact of Extent of Surgery on Survival for Papillary Thyroid Cancer Patients Younger Than 45 Years

2015 ◽  
Vol 100 (1) ◽  
pp. 115-121 ◽  
Author(s):  
Mohamed Abdelgadir Adam ◽  
John Pura ◽  
Paolo Goffredo ◽  
Michaela A. Dinan ◽  
Terry Hyslop ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Total Thyroidectomy ◽  
Papillary Thyroid Cancer ◽  
Extent Of Resection ◽  
Stage I ◽  
Papillary Thyroid ◽  
Cancer Data ◽  
Thyroid Lobectomy ◽  
Extent Of Surgery ◽  
The Impact

Abstract Context: Papillary thyroid cancer (PTC) patients &lt;45 years old are considered to have an excellent prognosis; however, current guidelines recommend total thyroidectomy for PTC tumors &gt;1.0 cm, regardless of age. Objective: Our objective was to examine the impact of extent of surgery on overall survival (OS) in patients &lt;45 years old with stage I PTC of 1.1 to 4.0 cm. Design, Setting, and Patients: Adult patients &lt;45 years of age undergoing surgery for stage I PTC were identified from the National Cancer Data Base (NCDB, 1998–2006) and the Surveillance, Epidemiology, and End Results dataset (SEER, 1988–2006). Main Outcome Measure: Multivariable modeling was used to compare OS for patients undergoing total thyroidectomy vs lobectomy. Results: In total, 29 522 patients in NCDB (3151 lobectomy, 26 371 total thyroidectomy) and 13 510 in SEER (1379 lobectomy, 12 131 total thyroidectomy) were included. Compared with patients undergoing lobectomy, patients having total thyroidectomy more often had extrathyroidal and lymph node disease. At 14 years, unadjusted OS was equivalent between total thyroidectomy and lobectomy in both databases. After adjustment, OS was similar for total thyroidectomy compared with lobectomy across all patients with tumors of 1.1 to 4.0 cm (NCDB: hazard ratio = 1.45 [confidence interval = 0.88–2.51], P = 0.19; SEER: 0.95 (0.70–1.29), P = 0.75) and when stratified by tumor size: 1.1 to 2.0 cm (NCDB: 1.12 [0.50–2.51], P = 0.78; SEER: 0.95 [0.56–1.62], P = 0.86) and 2.1 to 4.0 cm (NCDB: 1.93 [0.88–4.23], P = 0.10; SEER: 0.94 [0.60–1.49], P = 0.80). Conclusions: After adjusting for patient and clinical characteristics, total thyroidectomy compared with thyroid lobectomy was not associated with improved survival for patients &lt;45 years of age with stage I PTC of 1.1 to 4.0 cm. Additional clinical and pathologic factors should be considered when choosing extent of resection.

Loupe Magnification Reduces Postoperative Hypocalcemia after Total Thyroidectomy

2010 ◽  
Vol 76 (12) ◽  
pp. 1345-1350 ◽  
Author(s):  
Giacomo Pata ◽  
Claudio Casella ◽  
Francesco Mittempergher ◽  
Laura Cirillo ◽  
Bruno Salerni
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Total Thyroidectomy ◽  
Injury Rate ◽  
Laryngeal Nerve ◽  
Parathyroid Glands ◽  
Postoperative Hypocalcemia ◽  
Surgical Teams ◽  
Pathology Reports ◽  
The Impact ◽  
Loupe Magnification

We aimed to evaluate the impact of loupe magnification (LM) on incidental parathyroid gland removal (from pathology reports), hypocalcemia, and recurrent laryngeal nerve (RLN) injury after total thyroidectomy and answer the question of whether this tool should be always recommended for patient's safety. Between January 2005 and December 2008, 126 patients underwent total thyroidectomy with routine use of 2.5 X galilean loupes; their charts were compared with data on 118 patients operated on between January 1997 and December 2000 without LM (two different equally skilled surgical teams operating in the two periods). LM decreased the rate of inadvertent parathyroid glands removal (3.8 vs 7.8% of total parathyroid glands; P = 0.01), as well as of biochemical (20.6 vs 33.9%; P = 0.028) and clinical (12.7 vs 33%; P = 0.0003) hypocalcemia after thyroidectomy. All cases (16 of 16) of symptomatic hypocalcaemia in the LM group proved to be associated with parathyroidectomy vs 76.9 per cent (30 of 39) without LM ( P = 0.046). A trend toward decreased RLN injury rate, although statistically insignificant, was reported, being unilateral transient, unilateral permanent, and bilateral transient palsy rates 6.8, 2.5, and 1.7 per cent, respectively, without LM vs 4.8, 2.4, and 0.8 per cent, respectively, with LM ( P = 0.69; P = 1, and P = 0.61, respectively). Our results do support the routine use of LM during total thyroidectomy.

Thyroid cancer in Friuli Venezia Giulia, northeastern Italy: incidence, overdiagnosis, and impact of type of surgery on survival

2019 ◽  
Vol 105 (4) ◽  
pp. 296-303
Author(s):  
Chiara Panato ◽  
Diego Serraino ◽  
Emilia De Santis ◽  
Ornella Forgiarini ◽  
Tiziana Angelin ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Total Thyroidectomy ◽  
Cancer Registry ◽  
Population Based ◽  
Incidence Rates ◽  
European Population ◽  
Term Survival ◽  
The Impact ◽  
Type Of Surgery ◽  
Friuli Venezia Giulia

Background: Incidence rates of thyroid cancer (TC) increased in the last decades worldwide. This study aimed to describe TC incidence in the Friuli Venezia Giulia (FVG) region, to estimate the quota of overdiagnosis, and to investigate the impact of surgery on long-term survival after TC diagnosis. Methods: TC cases reported to the FVG population-based cancer registry during 2002–2013, aged <85 years, were included. Age standardized rates (ASR) on the European population were computed, while proportion of TC overdiagnosis was estimated in comparison with expected age-specific incidence rates from published time series. Adjusted hazard ratios of death, with 95% confidence intervals, were also estimated. Results: During 2002–2013, 1701 TC cases were reported to the FVG cancer registry, with papillary TC (78.2%) as the most frequent histologic type. ASR increased from 12.4 to 16.5 in women and from 4.3 to 6.2 in men (+33.1% and +44.2%, respectively). Overdiagnosis was estimated as 79% of TC cases in women and 64% in men. Almost all TC cases (97.1%) underwent surgery, including 84.6% of women and 78.9% of men who underwent total thyroidectomy. Up to 10 years after TC diagnosis, the type of surgery did not appear to influence survival. Conclusions: This study documented an increase in TC incidence in FVG in the last decade, with overdiagnosis accounting for a large proportion of TC diagnoses and total thyroidectomy in more than 80% of cases. These findings suggest reconsidering thyroid screening practice and aggressive therapeutic strategies, as recommended by new TC guidelines.

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