An Audit of the Procedure of Open Thyroidectomy at A Tertiary Care Centre

Monga, Rabia; Kanodia, Anupam; Kajal, Smile; Irugu, David Victor Kumar; Sikka, Kapil; Thakar, Alok; Kumar, Rakesh; Sharma, Suresh C.; Agarwal, Shipra; Shamim, Shamim Ahmed; Verma, Hitesh

doi:10.1007/s12070-020-02128-w

Cited by 2 publications

(4 citation statements)

References 27 publications

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“…Previous literature on ICG‐NIRF has similarly identified end‐thyroidectomy PG devascularization in 16%–31% 17,18 . Further, a higher incidence of transient and permanent hypocalcemia has been noted in patients undergoing CCND with total thyroidectomy 3,19–21 . Surgical dissection on the thyroid/parathyroid bed has been itself noted to increase the risk of devascularization 21 .…”

Section: Discussionmentioning

confidence: 99%

“…17,18 Further, a higher incidence of transient and permanent hypocalcemia has been noted in patients undergoing CCND with total thyroidectomy. 3,[19][20][21] Surgical dissection on the thyroid/parathyroid bed has been itself noted to increase the risk of devascularization. 21 This study did not note of increased PG devascularization rates by combining CCND with total thyroidectomy, but did note of significantly increased PG devascularization on the side ipsilateral to tumor as compared to PGs contralateral to the tumor side.…”

Section: Discussionmentioning

confidence: 99%

“…Temporary hypoparathyroidism is very frequent (5.94%–67.69%) following total thyroidectomy and the commonest cause for delay in hospital discharge 2 . Reported rates of permanent hypoparathyroidism following total thyroidectomy have ranged from 0% to 20% 2,3 . A recent contemporary report evaluating 200 patients from seven Dutch University hospitals noted of persistent hypoparathyroidism in 28.5% at 6 months post‐surgery and in 14.5% at 1‐year post‐surgery, and called for specific efforts to reduce this complication rate 4 …”

Section: Introductionmentioning

confidence: 99%

“…2 Reported rates of permanent hypoparathyroidism following total thyroidectomy have ranged from 0% to 20%. 2,3 A recent contemporary report evaluating 200 patients from seven Dutch University hospitals noted of persistent hypoparathyroidism in 28.5% at 6 months post-surgery and in 14.5% at 1-year post-surgery, and called for specific efforts to reduce this complication rate. 4 The vulnerability of the parathyroid glands (PG) to surgical injury and ischemia is well known, and contributed to by nature of their delicate vascular supply, small size, variable position, soft consistency, and an appearance not easily distinguishable from the surrounding fat lobules, lymph nodes and small thyroid nodules.…”

Section: Introductionmentioning

confidence: 99%

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Incremental value of magnification and indocyanine green for parathyroid preservation in thyroid surgery

et al. 2023

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Background: To assess the promise of surgical magnification and of intraoperative indocyanine green (ICG) assisted near-infrared fluorescence (NIRF) in improving parathyroid identification and viability assessment during thyroidectomy. Methods: Prospective comparative study. Parathyroid gland identification sequentially assessed by naked eye, surgical microscopy, and by NIRF imaging following ICG administration (5 mgIV). Parathyroid perfusion/vitality reassessed end-surgery by ICG-NIRF. Results: An expected total of 104 parathyroid glands were assessed in 35 patients (17 total-thyroidectomy, 18 hemi-thyroidectomy). 54/104 (51.9%) were identified by naked eye, and sequentially greater numbers identified by microscope magnification (n = 61; 58.7%; p = 0.33), and by ICG-NIRF (n = 72; 69.2%; p = 0.01). ICG-NIRF detected additional parathyroid glands in 16/35 patients (45.7%). Confident identification of at least one parathyroid remained unachieved in 5/35 by naked eye, in 4/35 by microscopic magnification, and in no patient by ICG-NIRF. ICG-NIRF indicated end-of-surgery devascularization in 12/72 glands and informed decisions regarding gland implantation. Conclusion: Significantly greater parathyroid glands are identified and preserved with surgical magnification and with ICG-NIRF. Both techniques merit routine adoption for thyroidectomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Incremental value of magnification and indocyanine green for parathyroid preservation in thyroid surgery

et al. 2023

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thyroidectomy complications after ligasure small jaw use, case control, prospective study

Alharbi

2023

Preprint

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Introduction: The ligasure small jaw (LISJ) has many advantages for thyroid surgery hemostasis. Other complications, however, remain at the same level or are even greater than with conventional treatment. Material and methodology: Between March and December of 2022, I analyzed complications following total thyroidectomy (TTH). Patients were evaluated prospectively for case control study. including hypocalcemia (HC) and recurrent laryngeal nerve (RLND) palsy. Results: all patients suffered from postoperative (HC) with Ca supplement with Vid D.one patient suffered with stridor after extubation. Conclusion: To reduce the complication rate during thyroid surgery with a small jaw, more surgical expertise is required. In terms of (RLND) palsy and (HC), the current literature does not demonstrate a safety advantage of (LISJ) over conventional thyroid surgery that would justify a price increase.

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An Audit of the Procedure of Open Thyroidectomy at A Tertiary Care Centre

Cited by 2 publications

References 27 publications

Incremental value of magnification and indocyanine green for parathyroid preservation in thyroid surgery

Incremental value of magnification and indocyanine green for parathyroid preservation in thyroid surgery

thyroidectomy complications after ligasure small jaw use, case control, prospective study

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