How to do it: the difficult thyroid

Upile, Tahwinder; Jerjes, Waseem; Mahil, Jaspal; Tailor, Hiteshkumar; Balakumar, Ramkishan; Rao, A. Anka; Qureshi, Yassar A.; Bowman, Iain; Mukhopadhyay, Suchana

doi:10.1186/1758-3284-3-54

Cited by 14 publications

(12 citation statements)

References 4 publications

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“…6 Hence, preventive measures have been emphasized and employed to avoid postoperational bleedings after thyroidectomy. These approaches range from exercises to avoid Valsalva maneuver kind of forces such as coughing or straining at opening bowel 7 to the use of drains after the operation. However, recent literature indicates that the drain usage does not have a significant effect on the recovery period or on the duration of the hospital stay.…”

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confidence: 99%

“…These techniques involve the use of hydrogen peroxide, water in the wound, Valsalva maneuver, and Trendelenburg tilt. 4,7 Recently, the success of Valsalva maneuver and Trendelenburg tilt application on bleeding point detection was demonstrated by Moumoulidis et al 4 However, no further information is provided until now regarding the postoperational evaluation of the patients.…”

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confidence: 99%

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Effect of Intraoperative Valsalva Maneuver Application on Bleeding Point Detection and Postoperative Drainage After Thyroidectomy Surgeries

Tokaç

Dumlu

Bozkurt

et al. 2015

International Surgery

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The purpose of this paper was to analyze the effect of Valsalva maneuver application before finalizing thyroidectomy operations on the identification of bleeding points and postoperational drainage. One hundred patients (age range, 24-76 years) with multinodular goiter, recurrent multinodular goiter, toxic diffuse multinodular goiter, or papillary thyroid cancer were included in the study and were divided into 2 groups of 50 randomly. Both groups underwent thyroidectomy operation, only 1 group received intraoperative Valsalva maneuver application (twice, 30 seconds of 30-cm PEEP). The size of the thyroid gland, the duration of operation, hospital stay, and drain usage were reported. Postoperational occurrences of drainage, hematoma, reoperation, and additional complications were compared between the groups. Valsalva maneuver application helped to identify minor bleeding points in 32% of the cases. There was no significant difference between the study groups regarding the thyroid gland size, operation duration, hospital stay, and the duration of drain usage (P . 0.05 for all). The amount of drainage as well as the frequencies of hematoma, reoperation, and further complications was not significantly different between the study groups (P . 0.05 for all). Intraoperative application of Valsalva maneuver is only useful to detect minor bleeding points in some patients during thyroidectomy operations, but it had no effect on the duration of postoperative drain usage, the amount of drainage, and risk of hematoma. Therefore, intraoperative application of Valsalva maneuver has no beneficial effect on postoperative hemorrhagic complication after thyroidectomy operations.

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confidence: 99%

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confidence: 99%

Effect of Intraoperative Valsalva Maneuver Application on Bleeding Point Detection and Postoperative Drainage After Thyroidectomy Surgeries

Tokaç

Dumlu

Bozkurt

et al. 2015

International Surgery

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“…[15][16][17][18] Traditionally cited factors contributing to difficulty in thyroid surgery include increased vascularity, inflammation, friability, fibrosis, and large gland size. [19][20][21] The thyroid surgery literature includes numerous examples of each individual item that comprises the Thyroidectomy Difficulty Scale.…”

Section: During the Late 19mentioning

confidence: 99%

Predicting difficulty of thyroidectomy preoperatively

Oommen

Remin

2017

Int Surg J

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Background: Today, thyroidectomy is a common operation used to treat various thyroid disorders. Nowadays, many high-volume thyroid surgeons are discharging patients on the same day of thyroidectomy. The incidence of complications following thyroidectomy is directly linked to the difficulty of the procedure. So, if we can predict the difficulty of thyroidectomy preoperatively, we can anticipate complications and decide on which patients will require in-patient care.Methods: A thyroidectomy difficulty scale was developed by Schneider and colleagues. This scale was used in our study to classify patients in to difficult thyroidectomy group and non-difficult thyroidectomy group. The association between preoperative variables and difficulty of thyroidectomy was studied.Results: Statistical analysis revealed that there was a significant association between hyperthyroidism and difficult thyroidectomy. Similarly, there was a significant association between positive anti-thyroid peroxidase antibody (which defines Hashimoto’s thyroiditis) and difficult thyroidectomy. Also, there was a significant association between positive anti-thyroglobulin antibody and difficult thyroidectomy. Difficult thyroidectomy was found to have a significant association with postoperative hypocalcemia. Statistical analysis also showed duration of surgery to have a significant association with difficulty of thyroidectomyConclusions: Patients with hyperthyroidism, positive anti-thyroid peroxidase antibodies, positive anti-thyroglobulin antibodies have a high probability of a difficult thyroidectomy, associated with longer operative times and increased complications. This information can improve preoperative risk counseling and lead to more efficient scheduling of the operating room.

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“…Hard Tissue will be also oriented towards the educational needs of postgraduates of dentistry, medicine and surgery and of related healthcare sciences by presenting the disorder in the context of the current knowledge of human pathophysiology and of clinical practice 29,36,37,52,53 .…”

Section: Trainingmentioning

confidence: 99%

“…Many advances from prosthesis development (with biointegration) to tissue engineering have seen significant leaps in patient treatments and outcomes. We will endeavour to promote and display good practice, recent advances and share significant advances in practice with 'tips and tricks' [35][36][37][38][39] . Implantation of advanced electronic devices (with their potential of remote programming) range from cochlear implants to brainstem and cortical implants which are beginning to open up the world of sound to those without noise.…”

Section: Otolaryngology With Head and Neck Surgerymentioning

confidence: 99%