In Spain, adrenalectomy is performed in hospitals of varying complexity. Laparoscopic approach is the rule, with good results in terms of morbidity and stay. High-volume centers and surgeons had best results in terms of use of minimally invasive surgery and hospital stay.
We report the case of a periampullary collision tumor, in which a duodenal-wall carcinoid and an adenocarcinoma of the head of the pancreas coexisted. We describe the case of a 64-year-old man with a recent history of diarrhea, who was diagnosed with obstructive jaundice. A duodeno-pancreatectomy was performed, and the specimen showed two independent neoplasms in the histopathologic study. Solid cords and nests of neuroendocrine cells in the duodenal wall formed the carcinoid tumor, whereas the other neoplasm was made up of a well-differentiated adenocarcinoma of the pancreas. Both were confirmed by immunohistochemical analysis. According to the literature reviewed, this is the sixth reported case of this rare neoplastic association.
Background and objective Hypocalcemia is one of the main complications of thyroid surgery. We hypothesized that hemithyroidectomy may have an impact on serum parathyroid hormone (PTH) and calcium levels despite only one thyroid lobe is manipulated. The objective of this study was to analyze changes in serum PTH and calcium levels following hemithyroidectomy. Methods This is a prospective study of 53 patients who underwent thyroid lobectomy. The serum PTH level was determined in the preoperative period, 15 min after extraction of the surgical specimen, and 24 h and 3 weeks after surgery. Serum ionized calcium was also measured in the preoperative period and at 6 h, 24 h and 3 weeks after surgery. We assessed the postoperative calcium value and its relationship with the extent of fall in PTH levels in the postoperative period. Results None of the patients had the postoperative serum ionised calcium level less than 4 mg/dl. The decrease in postoperative calcium was statistically significant at 6 and 24 h after surgery; there was no difference at 3 weeks post-surgery. The change in post-operative serum PTH levels followed a similar trend to postoperative serum calcium levels. Conclusions Although serum calcium level decreased after a lobectomy, it always remained above 4 mg/dl. We conclude that hypocalcaemia is rare following hemithyroidectomy.
Background and objective: Hypocalcemia is one of the main complications that patients undergoing thyroid surgery can suffer. We believe that there may be an impact on serum parathormone and calcium values, despite only one thyroid cell is manipulated in thyroid lobectomy. The former explanation is the reason because we carried out a measurement and analised a potential correlation between them. Methods: This is a prospective study of 53 patients underwent thyroid lobectomy. The serum parathormone value was determined in the preoperative period, 15 min after extraction of the surgical piece, 24 hours and 3 weeks after surgery. Ionic calcium was also measured at 6 hours, 24 hours and 3 weeks. Postoperative parathormone values were compared as well as their gradient descent respect to the postoperative calcium value. The appearance of the parathyroid glands was described during surgery. Results: In none of the patients did the ionic calcium drop below 4mg / dl. The decrease in preoperative calcemia compared with the values at 6 and 24 hours had statistical significance, there were no differences compared to 3 weeks experiment. An analogous trend was observed between the percentage values of decrease in parathormone and postoperative calcemia. Conclusions: Although the calcemia decreased after a lobectomy, it always remained above 4 mg / dl. We conclude that hemithyroidectomy is a safe technique regarding the appearance of hypocalcemia in the postoperative period.
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