The Preferred Option for Multinodular Goiter

Reeve, T. S.; Delbridge, Leigh; Cohen, A; Crummer, Patsy

doi:10.1097/00000658-198712000-00016

Cited by 215 publications

(179 citation statements)

References 7 publications

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“…The main objection about performing TT has been the higher likelihood of damage to the RLN and induction hypoparathyroidism [6]. However the incidences of permanent RLN injury and permanent hypoparathyroidism associated with thyroid reoperations have been reported to range between 3.1% and 9.5% and between 3.4% and 14% respectively [20,22]. Pappalardo et al reported a rate of recurrence up to 14.5% after subtotal resection in their study, even though pharmacological prophylaxis was given [4].…”

Section: Discussionmentioning

confidence: 99%

The Factors Related with Postoperative Complications in Benign Nodular Thyroid Surgery

et al. 2010

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Thyroid gland is an important endocrine organ because of its functions. Although the morbidity and mortality of thyroid surgery have decreased markedly, serious complications may still occur. The aim of this retrospective study was to identify the factors influencing the complications in benign nodular thyroid surgery. A total of 332 patients who underwent thyroid surgery between April 2004 and May 2008 were evaluated retrospectively to identify the factors influencing the complications. We found that in surgery lasting more than 90 minutes the risk of permanent recurrent laryngeal nerve (RLN) injury was high, daily drainage more than 50 cc increases the risk of seroma formation, retrosternal goiter surgery have higher risk for bleeding. The flap edema rates were high found in the operations made by resident surgeon and patients with size 3-4 thyroid glands. Low complication rates can be achieved after thyroidectomy with better knowledge of the surgical anatomy of the neck, thyroid pathology and required surgical treatment.

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Section: Discussionmentioning

confidence: 99%

The Factors Related with Postoperative Complications in Benign Nodular Thyroid Surgery

et al. 2010

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“…çalışmasında, 1975-1984 dö-neminde yapılan 789 tiroidektomi ameliyatında kardiyak nedenlerden kaynaklanan 2 postoperatif ölüm görüldüğünü, TT ameliyatının rutin hâle geldiği 1985 yılında yapılan 64 tiroidektomi ameliyatında ölüm görülmediğini bildirmiştir. 44 Çalışma-mızda hematom gelişen olgulardan 2'si havayolu obstrüksiyonu nedeniyle 1. ve 5. günlerde kaybedilmiş; postoperatuar dönemde hipoksik ansefalopati gelişen üçüncü olgu ise ameliyattan 10 ay sonra vefat etmiştir. Postoperatuar dönemde solunum sıkıntısı gelişmesi nedeniyle trakeostomi açılan bir olgunun da ameliyattan 41 gün sonra kanülü çıkarılırken kanül kenarından oluşan kanamaya bağlı gelişen hipoksi nedeniyle kaybedildiği gözlenmiştir.…”

Section: Discussionunclassified

Retrospective Analysis of Thyroidectomy Cases That Became Subjects Due to Unintended Consequences

Erkol¹,

Ertan²,

Gökdoğan³

et al. 2012

Turkiye Klinikleri J Med Sci

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Ö ÖZ ZE ET T A Am ma aç ç: : Çalışmada; dava konusu olan tiroid cerrahi girişimlerinin risk alanının belirlenmesi, başta genel cerrahi uzmanları olmak üzere tüm sağlık çalışanlarına olguların verileri konusunda geri bildirimde bulunulması amaçlandı. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : 2006-2009 yıllarında Adli Tıp Kurumu Adli Tıp 3. İhtisas Kurulu'nda tiroid cerrahisine bağlı olarak istenmeyen sonuçlar gelişmiş olgular hakkında düzenlenen bilirkişi raporları retrospektif olarak incelendi. Veriler SPSS 13,0 Paket Programı ile değerlendirildi. B Bu ul lg gu ul la ar r: : Toplam 28 olgunun 23'ü (%82,2) kadın, 5'i (%17,8) erkekti. Ortalama yaş 41,3 bulundu. Olguların 13'ü (%46,5) multinodüler guatr (MNG), 3'ü (%10,7) toksik MNG, 2'si (%7,1) nodüler guatr, 2'si (%7,1) Basedow Graves, 2'si (%7,1) kronik lenfositik tiroidit, 2'si (%7,1) nüks guatr, 1'er (%3,6) olgu ise papiller karsinom, anaplastik karsinom, folliküler adenom nedeniyle ve dosyada belirtilmeyen nedenle opere edilmişti. Yirmi bir (%75,0) olguya subtotal tiroidektomi, 7 (%25,0) olguya total tiroidektomi uygulanmıştı. İstenmeyen sonuç olarak olguların 10'unda hipoparatiroidi, 7'sinde tek taraflı vokal kord paralizisi, 5'inde bilateral vokal kord paralizisi, 3'ünde hematom ve 1'er olguda hematom + bilateral vokal kord paralizisi, trakeostomi kanülü kenarından kanama ve özofagus yaralanması meydana gelmişti. Bilirkişi kararlarında 21 olguda uygulanan tedavinin tıp kurallarına uygun olduğu, 6 olguda tıbbi uygulama hatası bulunduğu, 1 olguda tıbbi uygulama hatası yönünden görüş bildirilemeyeceği ifade edilmişti. S So on nu uç ç: : İstenmeyen sonuç gelişen olguların bilimsel ortamlarda tartışılmasının riskin azaltılmasında faydalı olabileceği düşünülmektedir.A An na ah ht ta ar r K Ke el li im me el le er r: : Tiroidektomi; komplikasyonlar; malpraktis A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The aim of to this study was determine the risk area of surgical interventions of the thyroid that became subjects, and to provide feedback about the data of the cases mainly to general surgeons and all health care providers. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Legal expert reports written by the Third Specialized Board of Council of Forensic Medicine between 2006-2009 about cases that developed unintended consequences due to thyroid surgery were analyzed retrospectively. Data were assessed with SPSS 13.0 package program. R Re es su ul lt ts s: : Of a total of 28 cases, 23 (82.2%) were females and 5 (17.8%) were males. Mean age was 41.3 years. Of the cases, 13 (46.5%) were operated on for multinodular goitre (MNG), 3 (10.7%) for toxic multinodular goitre (MNG), 2 (7.1%) for nodular goitre, 2 (7.1%) for Basedow-Graves, 2 (7.1%) for chronic lymphocytic thyroiditis, 2 (7.1%) for recurrent goitre, 1 (3.6%) for papillary carcinoma, 1 (3.6%) for anaplastic carcinoma, 1 (3.6%) for follicular adenoma and 1 (3.6%) for a reason not stated in the file. Twenty-one (75.0%) cases underwent subtotal thyroidectomy and 7 (25.0%) cases...

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“…Total thyroidectomy has been established as the preferred operation for a range of thyroid pathologies including thyroid cancer, multinodular goitre (MNG) and Graves' disease. [1][2][3] Postoperative hypocalcaemia is the most common complication observed in patients undergoing total thyroidectomy, with a reported incidence ranging from 1.6% to 50%. [4][5][6][7][8] Transient hypocalcaemia occurs in upto 50% of patients and permanent hypocalcaemia in 2%.…”

Section: Introductionmentioning

confidence: 99%

Measurement of intact parathormone after one hour of total thyroidectomy: a predictor of symptomatic hypocalcemia

2017

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Background: Hypocalcemia is one of the most common complications of thyroidectomy. Hence, parathyroid hormone (PTH) measurement can be used to predict patients at risk for developing significant postoperative hypocalcaemia after thyroidectomy. The present study was conducted with the objective to find out whether there is any correlation between intact PTH value and patients developing symptoms of hypocalcemia after total thyroidectomy and to determine the threshold value of 1 hour post total thyroidectomy (intact PTH level) that can identify those at high risk for developing symptomatic hypocalcemia.Methods: Study involved determination of serum calcium, creatinine and albumin preoperatively, serum intact PTH, 1 hour after completion of total thyroidectomy (i.e. after the closure of skin incision), and serum calcium levels 6, 24 and 48 hours postoperatively. Clinical findings suggestive of hypocalcaemia were also watched for and recorded. Symptomatic signs and/or symptoms were recorded. The patients were followed up for 3 days post operatively and the lowest recorded serum calcium was taken into account. The results were tabulated and entered in Microsoft excel and analysed with spss 17 statistical software.Results: 26% of the study population developed hypocalcemia. Intact PTH was found to be lower in patients who developed symptoms of hypocalcemia. There was a statisticantly significant correlation between the two groups. A one-hour Intact PTH value of 14 pg/ml was found to have high sensitivity (92.3%) and specificity (91.9%).Conclusions: Hypocalcemia is the most common complication after total thyroidectomy. Intact PTH measurement one hour after total thyroidectomy can be used to predict the patients who will develop hypocalcemia after total thyroidectomy. Therefore, patients having low one-hour intact PTH value could be started on calcium supplementation and those having high PTH could be safely discharged early.

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The Preferred Option for Multinodular Goiter

Cited by 215 publications

References 7 publications

The Factors Related with Postoperative Complications in Benign Nodular Thyroid Surgery

The Factors Related with Postoperative Complications in Benign Nodular Thyroid Surgery

Retrospective Analysis of Thyroidectomy Cases That Became Subjects Due to Unintended Consequences

Measurement of intact parathormone after one hour of total thyroidectomy: a predictor of symptomatic hypocalcemia

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