Covid
Seyed Vahid Seyed Hosseini
Abstract
Thyroidectomy, the surgical removal of the thyroid gland, is a commonly performed procedure for various thyroid conditions. In recent years, laparoscopic thyroidectomy (LT) has emerged as a minimally invasive alternative to open thyroidectomy (OT). This abstract presents a comparison of the results between ...
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Thyroidectomy, the surgical removal of the thyroid gland, is a commonly performed procedure for various thyroid conditions. In recent years, laparoscopic thyroidectomy (LT) has emerged as a minimally invasive alternative to open thyroidectomy (OT). This abstract presents a comparison of the results between laparoscopic and open thyroidectomy, specifically focusing on surgical efficacy, safety, postoperative complications, and patient satisfaction. Several studies have reported comparable or even superior outcomes with laparoscopic thyroidectomy in terms of surgical efficacy. LT provides magnified visualization and improved access to the surgical field, resulting in lower rates of nerve injury and hypoparathyroidism, while achieving equivalent rates of complete tumor resection and lymph node dissection. In terms of safety, laparoscopic thyroidectomy has demonstrated advantages over open thyroidectomy. It is associated with reduced blood loss, lower rates of wound infections, decreased postoperative pain, and improved cosmetic outcomes due to smaller incisions. However, the learning curve for surgeons must be considered, as adequate training and experience are crucial for ensuring patient safety during laparoscopic procedures. Studies consistently report lower rates of postoperative complications with laparoscopic thyroidectomy, including wound infections, hematoma formation, seroma formation, and postoperative hypoparathyroidism. The incidence of recurrent laryngeal nerve injury is also lower with laparoscopy. Patient satisfaction tends to be higher with laparoscopic thyroidectomy due to reduced postoperative pain, faster recovery, improved cosmetic outcomes, and shorter hospital stays. In conclusion, laparoscopic thyroidectomy offers potential benefits in terms of surgical efficacy, safety, lower rates of postoperative complications, and higher patient satisfaction compared to open thyroidectomy.
Medicine
Moen Hosein Pour Feyzi; Ahmad Sheykhloo
Abstract
Thyroidectomy is a common surgical procedure performed to treat various thyroid disorders. In recent years, advancements in surgical techniques and perioperative management have contributed to improved outcomes and reduced complications. This scoping review aims to provide a comprehensive overview of ...
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Thyroidectomy is a common surgical procedure performed to treat various thyroid disorders. In recent years, advancements in surgical techniques and perioperative management have contributed to improved outcomes and reduced complications. This scoping review aims to provide a comprehensive overview of modern surgical techniques and perioperative complications management in thyroidectomy. The review encompasses a wide range of literature, including original research studies, systematic reviews, and clinical guidelines. It explores various modern surgical techniques employed in thyroidectomy, such as minimally invasive approaches (e.g., endoscopic and robotic-assisted), intraoperative nerve monitoring, and indocyanine green fluorescence imaging. The benefits, limitations, and outcomes associated with these techniques are discussed, highlighting their impact on surgical precision, postoperative recovery, and patient satisfaction. Additionally, the review addresses the perioperative complications management in thyroidectomy, focusing on key areas such as bleeding, recurrent laryngeal nerve injury, hypocalcemia, and surgical site infection. It discusses the identification and management of risk factors, the role of advanced imaging and monitoring techniques, and the importance of multidisciplinary collaboration in optimizing patient outcomes. Overall, this scoping review provides a comprehensive synthesis of the current evidence on modern surgical techniques and perioperative complications management in thyroidectomy. It serves as a valuable resource for surgeons, healthcare professionals, and researchers, offering insights into the advancements, challenges, and future directions in this field, ultimately contributing to improved patient care and surgical practice.
Medicine
Ali Sharifi; Fariborz Rousta
Abstract
Introduction: Post-thyroidectomy hypocalcemia is a significant complication that can occur following thyroid surgery. Patient-related factors, surgical factors, and pathological factors contribute to the development of hypocalcemia. Prompt recognition, appropriate management, and preventive measures ...
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Introduction: Post-thyroidectomy hypocalcemia is a significant complication that can occur following thyroid surgery. Patient-related factors, surgical factors, and pathological factors contribute to the development of hypocalcemia. Prompt recognition, appropriate management, and preventive measures are essential to minimize the occurrence of hypocalcemia and its associated complications.Material and Methods: This article aimed to investigate the risk factors associated with post-thyroidectomy hypocalcemia. A retrospective cohort study design was employed to analyze data from patients who underwent thyroidectomy at a single institution. The study period spanned from January 2018 to December 2020. The study protocol was approved by the Institutional Review Board (IRB) of the institution.Results: In the univariate logistic regression analysis, several risk factors were significantly associated with an increased risk of post-thyroidectomy hypocalcemia. Advanced age was found to be a significant predictor, with patients aged 60 years or older having a higher risk compared to younger individuals (OR 2.4, 95% CI 1.5-3.8, p<0.001). Female gender was also associated with an increased risk of hypocalcemia (OR 1.8, 95% CI 1.2-2.7, p=0.005)Conclusion: this study identified several risk factors associated with post-thyroidectomy hypocalcemia, including advanced age, female gender, lower preoperative calcium levels, total thyroidectomy, presence of thyroid cancer, and extensive thyroid gland involvement. These findings can aid in preoperative risk stratification, surgical planning, and patient counseling.
Medicine
Abdolreza Mehdinavaz Aghdam; Fariborz Rousta
Abstract
Introduction: Another rare surgical cause of voice change after thyroidectomy is cervical muscle injury Causes of failure may include pulmonary edema, edema, or airway obstruction. The aim of this study was to determine the frequency of unplanned parathyroidectomy, unplanned parathyroidectomy, postoperative ...
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Introduction: Another rare surgical cause of voice change after thyroidectomy is cervical muscle injury Causes of failure may include pulmonary edema, edema, or airway obstruction. The aim of this study was to determine the frequency of unplanned parathyroidectomy, unplanned parathyroidectomy, postoperative hypocalcemia and the risk of unplanned parathyroidectomy in patients undergoing thyroid surgery in our clinic. Material and Methods: Comparison of postoperative Ca value with age, gender, preoperative Ca value, dominant nodule diameter on ultrasonography (USG), type of surgery (total/lobectomy), and histopathological findings of thyroidectomy material (malignant/benign, with or without incident parathyroidectomy) is closed. Blood calcium levels below 8 mg/dL, measured after the first 24 hours after surgery, are indicative of postoperative hypocalcemia. Results: There was no relationship between nodule diameter and hypocalcemia. When patients were divided into malignant and benign groups, there was no significant difference between these groups in terms of performance after hypocalcemia. When patients were divided into groups with and without incident parathyroidectomy, there was no significant difference in postoperative hypocalcemia between these groups. Conclusion: In our study, female gender, age <28.5 years, low preoperative Ca value and total thyroidectomy were considered to be associated with hypocalcemia. Although there is no association between parathyroidectomy and postoperative hypocalcemia, this problem can be avoided by careful removal and imaging of the thyroid gland, especially in patients including patients with malignant thyroidectomy and total thyroidectomy.
Covid
Abdolreza Mehdinavaz Aghdam; Fariborz Rousta
Abstract
Introduction: The aim of this study was to determine the outcome of low PTH after surgery and to monitor parathyroid recovery times in patients who underwent total thyroidectomy. Material and Methods: A commercially available PTH (iPTH) test was used to monitor iPTH levels on days 1 and 4. PTH levels ...
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Introduction: The aim of this study was to determine the outcome of low PTH after surgery and to monitor parathyroid recovery times in patients who underwent total thyroidectomy. Material and Methods: A commercially available PTH (iPTH) test was used to monitor iPTH levels on days 1 and 4. PTH levels were negative. It is determined by the same blood test as the sCa level. To exclude vitamin D deficiency, we first measured 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels in all patients Postoperative hypoparathyroidism was defined as postoperative albumin-adjusted sCa levels below 1.9 mmol/L (Convert to mg/dL, divide) with 0.25 (range of use, 2.10-2.60 mmol/L) symptoms of hypocalcemia (response to neuromuscular stress including paresthesias, muscle spasms, tetany or seizures) or sCa levels lower than results (1.9-2.1 mmol/L) with neuromuscular symptoms during the first 4 days after surgery. Results: In a multivariate logistic regression model, we found that patients who received an autograft of parathyroid tissue during surgery were more likely to have low PTH immediately after surgery (OR = 2.6; 95% CI, 1.8-3.8). Additionally, patients with parathyroid tissue who showed negative parathyroid tissue removal on the final pathology report were more likely to have postoperative PTH <10 pg/mL (OR = 2.2; 95% CI, 1.5 -3.3). Parathyroid tissue was the only risk factor for permanent hypoparathyroidism in the pathology report (OR = 3.6, 95% CI, 1.1–11.5). Conclusion: This study suggests that drug therapy should be considered in addition to PTH measurement, as 50% of patients with persistent hypoparathyroidism have elevated PTH levels to ≥10 pg/mL, but still want more help to avoid hypoparathyroidism. Symptoms of calcemia. In addition, 12 months may be the most appropriate time to define persistent hypoparathyroidism, as 5% of patients with low PTH resolve 6-12 months after treatment.
