Surgical Management of a Complete Section of the Oesophagus During Total Thyroidectomy

Ibáñez, Javier; Ballester, Neus; García-Domínguez, Rafael; Urbaneja, Javier Vaqué; Navarro, Fernando Mingol

doi:10.1016/j.cireng.2017.03.004

Cited by 1 publication

(1 citation statement)

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“…The authors report a rare case of a complete lesion of the cervical esophagus during thyroidectomy. Literature describes few cases of esophagus lesion during thyroidectomy more frequently represented by perforation or partial injury, whereas only one case with complete resection is reported ( 18 - 20 ). Here, the case was analyzed from a medico-legal point of view, evaluating if a malpractice profile could emerge from the patient diagnostic-therapeutic process.…”

Section: Introductionmentioning

confidence: 99%

Professional liability due to complete esophagus section during thyroidectomy: a rare case report

Mondello¹,

Baldino²,

Cianci³

et al. 2023

Gland Surg

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Background: Several diagnostic and therapeutic processes are regulated by guidelines and recommendations provided by International and National Societies which offer standardized indications for health-care practitioners, including the treatment of pathologies that may affect the thyroid gland.These documents are very important for patient health promotion and, also, for preventing adverse events associated with patient injuries and related malpractice litigations. Particularly, thyroid surgery can be a cause of professional liability due to complications from surgical errors. Even if the most frequent complications are hypocalcemia and recurrent laryngeal nerve injury, this surgical specialty can be also burdened by other rare and serious adverse events such as esophagus lesions.Case Description: Here a case of alleged medical malpractice involving a 22-year-old woman reporting a complete esophagus section during thyroidectomy was described. The case analysis highlighted that the surgical treatment was performed for an unconfirmed Graves-Basedow disease which was then assessed as Hashimoto thyroiditis by histological exam of the removed gland. The esophagus section was treated by termino-terminal pharyngo-jejunal anastomosis and termino-terminal jejuno-esophagus anastomosis. The medico-legal analysis of the case revealed two different profiles of medical malpractice related, respectively, to the misdiagnosis of the pathology due to an inappropriate diagnostic-therapeutic procedure and the production of the complete section of the esophagus, representing an extremely rare complication of thyroidectomy.Conclusions: Clinicians should ensure an adequate diagnostic-therapeutic path based on guidelines, operational procedures, and evidence-based publications. The non-observance of the "required rules" for diagnosis and treatment of thyroid disease can be associated with a very rare and severe complication that strongly compromises the patient quality of life.

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Section: Introductionmentioning

confidence: 99%