Vignette Thyroid Surgery: A Glimpse Into its History

Abstract

At present, physicians and surgeons treating thyroid disorders can rely on highly accurate and precise investigations, modern equipment, and state of the art operating theater to achieve optimum results; however, this was not the case at the beginning of the treatment of thyroid diseases centuries ago. We present a short history of the treatment and understanding of thyroid diseases in the past few decades. Also we present the contributions of the important surgeons who tried to perfect the treatment of thyroid diseases, including surgery, thus making modern day management easier.

Association of Surgeon Volume With Outcomes and Cost Savings Following Thyroidectomy

“…For the period of 1996 through 2006, there was a 39% increase in the number of patients undergoing thyroid surgery. [1][2][3][4][5][6] Emerging evidence is showing that a surgeon's expertise and case volume has a substantial effect on the outcomes of thyroid procedures. Many studies have demonstrated improved clinical outcomes for different surgical interventions in patients treated by higher-volume surgeons.…”

Outcomes in thyroid surgery are affected by racial, economic, and healthcare system demographics

“…For the period of 1996 to 2006, there was a 39% increase in the number of patients undergoing thyroid surgery. Perhaps due to advances in surgical technique augmented by new technologies, such as neural monitoring, these patients generally enjoy a favorable outcome …”

“…Perhaps due to advances in surgical technique augmented by new technologies, such as neural monitoring, these patients generally enjoy a favorable outcome. [2][3][4][5][6][7] Patients' environments and living conditions have been identified as underlying factors that influence the presentation and outcome of certain diseases. [8][9][10][11][12][13][14] These factors are defined as the collective geographical, social, economic attributes of a specific environment, including urbanization, neighborhood educational level, racial demographics , dominant health behaviors, social support system, governing policies, and income status.…”

Thyroid Surgery Throughout History

“…Despite his initial lack of success during his tenure at the University of Zurich (8 of his 20 patients died perioperatively), he later reprised his efforts, taking advantage of all the innovations that had been undertaken in daily practice. Consequently, the mortality he reported only 6 years after, in Vienna, was less than 10% (14). His technique was still flawed in that he was quick to extirpate the gland with little or no regard for careful and meticulous blood vessel ligation, which often resulted in postoperative tetany.…”

“…Using this practise, he managed a wondrous 230 surgeries for exophthalmic thyreotoxic goitre and only 3% mortality rate (20,21). He also described sternotomy as a valid step in excising voluminous intrathoracic goitres (14).…”