Total thyroidectomy for benign thyroid disease

Liu, Qiang; Djuricin, Goldie; Prinz, Richard A.

doi:10.1016/s0039-6060(98)70221-1

Cited by 155 publications

(121 citation statements)

References 19 publications

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“…[13][14][15][16] TT, karsinomlar dışında, benign tiroid hastalıklarından her iki lobu tutan MNG, toksik MNG, kompresyon semptomları bulunan olgular, baş-boyun bölgesi radyasyona maruz kalmış olgular ve malignite şüphesi bulunan olgularda da uygulanabilmektedir. 13,15,[17][18][19][20] Bu çalışmada TT uygulanan 7 olgudan 2'sinde toksik MNG, 2'sinde MNG, 1'inde papiller karsinom, 1'inde anaplastik karsinom, 1'inde Basedow Graves olduğu görüldü. Çalışmamızda TT'nin olguların sadece %25,0'inde uygulandığı dikkate alındığında, günümüzde ülkemiz için TT'nin özellikle benign tiroid hastalıklarında genel olarak tercih edilen bir yöntem olmadığı söylenebilir.…”

Section: Discussionunclassified

“…18,[22][23][24][25][26][27][28] Ameliyat esnasında rekürrent laringiyal sinir (RLS)'in gözlenmesi, paratiroid bezlerin kanlanmasının korunması ve iyi bir hemostaz sağlanması ile komplikasyon oranlarının düşürülebileceği ifade edilmektedir. 19,29,30 Tiroidektomi sonrası görülen hipokalseminin nedeni sıklıkla paratiroid bezlerinin diseksiyon esnasında beslenmesinin bozulması ve iskemiye uğraması ya da iyatrojenik olarak paratiroid bezlerin çıkarılma-sıdır. 31,32 Bu çalışmada olguların 10'unda hipoparatiroidi gelişmişti.…”

Section: Discussionunclassified

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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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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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“…These lesions could be benign or malignant and the pathological nature of the goiter is established by fine needle aspiration cytology .Computerized tomography scan is an useful imaging modality especially in complicated massive goiter, in delineating the degree of tracheal compression and deviation and establishing the extent of retrosternal extension [7,10,19]. Most of these patients with massively enlarged goiters are managed by total thyroidectomy [20]. Total thyroidectomy is preferred as 10 to 20% recurrence has been observed in patients with lesser surgery [20].…”

Section: Discussionmentioning

confidence: 99%

“…Most of these patients with massively enlarged goiters are managed by total thyroidectomy [20]. Total thyroidectomy is preferred as 10 to 20% recurrence has been observed in patients with lesser surgery [20]. In such patients postoperative thyroxine may fail to prevent recurrence suggesting the glands are becoming increasingly autonomous during growth [20].…”

Section: Discussionmentioning

confidence: 99%

“…Total thyroidectomy is preferred as 10 to 20% recurrence has been observed in patients with lesser surgery [20]. In such patients postoperative thyroxine may fail to prevent recurrence suggesting the glands are becoming increasingly autonomous during growth [20]. Moreover surgery for recurrent goiter carries a 10 fold higher complication rate with complications such as permanent hypoparathyroidism (3.4%) and recurrent laryngeal nerve palsy (8%) [3,20].…”

Section: Discussionmentioning

confidence: 99%

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Thyroidectomy for Massive Goiter Weighing more than 500 Grams. Technical Difficulties, Complications and Management. Review

Machado¹

2011

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Background: Multinodular goiter is a relatively common thyroid disorder with a marked female preponderance. Most of these goiters weigh less than 100 grams with those weighing more than 500 grams being exceptional. The massively expanding goiter due to the strategic anatomic location of thyroid gland, in addition to being cosmetically disfiguring can seriously compromise the patency of the trachea and oesophagus. Thyroidectomy for such goiters is a surgical challenge due to the possible association of tracheomalacia, retrosternal extension, skin involvement and the difficulty in intubation and dissection of the thyroid gland due to distorted and displaced anatomy. Material and methods: While presenting 2 patients who underwent thyroidectomy for glands weighing more than 500 grams, the literature is reviewed to analyze the technical difficulties and approach in such patients and the frequently encountered complications in them and their management. Results: A review of the literature revealed an additional 7 cases of patients who had undergone thyroidectomy for glands weighing more than 500 grams. Massively enlarged goiter was often associated with tracheomalacia, tracheal stenosis and retrosternal extension. Difficulty during surgery was most often encountered in establishing the airway and in exposure of the gland particularly when the skin was involved. The predominant postoperative complications were related to respiratory distress as a consequence of tracheomalacia and tracheal stenosis. Conclusion: In spite of the technical challenge related to the airway, and thyroidectomy, surgery continues to be the best option in experienced hands due to its distinct advantage of its immediate effect and complete resolution of compressive symptoms.

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Thyroidectomy for Selected Patients With Thyrotoxicosis

Mittendorf

McHenry

2001

Arch Otolaryngol Head Neck Surg

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Massive thyroid enlargement with compressive symptoms, a dominant nodule, and patient preference are indications for surgical treatment of thyrotoxicosis. Near-total or total thyroidectomy is safe and more effective than subtotal thyroidectomy in preventing recurrence and should be considered in most patients referred for surgical treatment of thyrotoxicosis. Transient postoperative hypocalcemia is common and is related to the severity of thyrotoxicosis.

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Total thyroidectomy for benign thyroid disease

Cited by 155 publications

References 19 publications

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

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

Thyroidectomy for Massive Goiter Weighing more than 500 Grams. Technical Difficulties, Complications and Management. Review

Thyroidectomy for Selected Patients With Thyrotoxicosis

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