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total thyroidectomy is safer with identification of recurrent laryngeal nerve

Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2008年第6期9卷 482-488页

作者： Hakan CANBAZ Musa DIRLIK Tahsin COLAK Koray OCAL Tamer AKCA Oner BILGIN Bahar TASDELEN Suha AYDIN Department of General Surgery Faculty of MedicineMersin University Department of Biostatistics Faculty of MedicineMersin University

Objective:To investigate the effect of recurrent laryngeal nerve(RLN)identification on the complications after total thyroidectomy and ***:total 134 consecutive patients undergoing total thyroidectomy or thyroid lobectomy from January 2003 to November 2004 were investigated *** were divided into two groups:RLN identified (Group A)or not(Group B).The two groups were compared for RLN injury and ***:The numbers of patients and nerves at risk were 71 and 129 in Group A,and 63 and 121 in Group B,*** injury in Group A(0)was sig- nificantly lower than that in Group B(57.9%)patients,75.8%nerves)for the numbers of patients(P=0.016)and nerves at risk (P=0.006).Temporary hypocalcaemia was significantly higher in Group A than in Group B(1424.1%vs 610.3%,P=0.049). Permanent complications in Group B were significantly higher than those in Group A(1320.6%vs 45.6%,P=0.009).Con- clusion:RLN injury was prevented and permanent complications were decreased by identifying the whole course and branches of the recurrent laryngeal nerve during total thyroidectomy.

关键词： total thyroidectomy Lobectomy Recurrent laryngeal nerve (RLN) identification Complication

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Drainage after total thyroidectomy or lobectomy for benign thyroidal disorders

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2008年第4期9卷 319-323页

作者： Tahsin COLAK Tamer AKCA Ozgur TURKMENOGLU Hakan CANBAZ Bora USTUNSOY Arzu KANIK Suha AYDIN1 Department of General Surgery Medical Faculty of Mersin University 33079 Mersin Turkey Department of Biostatistics Medical Faculty of Mersin University 33079 Mersin Turkey

Objective: This prospective randomized clinical trial was conducted to evaluate the necessity of drainage after total thyroidectomy or lobectomy for benign thyroidal disorders. Methods: A total of 116 patients who underwent total thyroidectomy or lobectomy for benign thyroidal disorders were randomly allocated to be drained or not. Operative and postoperative outcomes including operating time, postoperative pain assessed by visual analogue scale (VAS), total amount of intramuscular analgesic administration, hospital stay, complications, necessity for re-operation and satisfaction of patients were all assessed. Results: The mean operating time was similar between two groups (the drained and non-drained groups). The mean VAS score was found to be significantly low in the non-drained group patients in postoperative day (POD) 0 and POD 1. The mean amount of intramuscular analgesic requirement was significantly less in the non-drained group. One case of hematoma, two cases of seroma and three cases of transient hypoparathyroidism occurred in the non-drained group, whereas one case of hematoma, two cases of seroma, two cases of wound infections and two cases of transient hypoparathyroidism occurred in the drained group. No patient needed re-operation for any complication. The mean hospital stay was significantly shorter and the satisfaction of patients was superior in the non-drained group. Conclusion: These findings suggest that postoperative complications cannot be prevented by using drains after total thyroidectomy or lobectomy for benign thyroid disorders. Furthermore, the use of drains may increase postoperative pain and the analgesic requirement, and prolong the hospital stay. In the light of these findings, the routine use of drains might not be necessary after thyroid surgery for benign disorders.

关键词： Analgesic requirement Complications Drainage Postoperative pain total thyroidectomy

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Evaluation of the Morbidity and Complications of total thyroidectomy: Systematic Literature Review

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Surgical Science 2022年第8期13卷 374-380页

作者： Huzifa Abdalla Abdelrahman Ahmed Nessrin Nasraldin Yousif Suliman Abazar Ammar Abdelghafar Elfaki Faculty of Medicine Sudan International University Sudanese Medical Research Association (SMRA) Khartoum Sudan Faculty of Medicine Shendi University Khartoum Sudan Faculty of Medicine International University of Africa Sudanese Medical Research Association (SMRA) Khartoum Sudan

This scientific problem is aiming to talk about the evaluation of morbidity and complications of total thyroidectomy. The presented review was conducted by searching in Medline, Embase, Web of Science, Science Direct, BMJ journal, and Google Scholar for, researches, review articles, and reports, published over the past years, which was searched up to June 2021 for published and unpublished studies and without language restrictions. If limitless lookup had comparable findings, we randomly chosen one or two to keep away from repetitive results. Based on the findings and effects of this review, the success of total thyroidectomy will beautify if we furnish large cognizance to advances in intervention, developing new methods and education. Surgeon responsiveness, nursing training will aid too in accomplishing this goal.

关键词： total thyroidectomy Graves’ Disease Complications Morbidity

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Classic clamp-and-tie total thyroidectomy for large goiters in the modern era:To drain or not to drain?

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World Journal of Otorhinolaryngology 2014年第1期4卷 1-5页

作者： Theodossis S Papavramidis Ioannis Pliakos Nick Michalopoulos George Mistriotis Niko Panteli George Gkoutzamanis Spiros Papavramidis 3rd Department of Surgery AHEPA University HospitalAristotle University of Thessaloniki54655 ThessalonikiGreece

AIM: To evaluate the role of drains in clamp-and-tie total thyroidectomy(c TT) for large goiters. METHODS: A hundred patients were randomized into group D(drains maintained for 24 h) and ND(no drains). We recorded epidemiological characteristics, thyroid pathology, hemostatic material, intraoperative events, operative time and difficulty, blood loss, biochemical and hematological data, postoperative vocal alteration and pain, discomfort, complications, blood in drains, and ***: The groups had comparable preoperative characteristics, pathology, intraoperative and postoperative data. Hemostatic material was used in all patients of group ND. Forty patients in group D and 9 in ND felt discomfort(P < 0.001). CONCLUSION: Drains in c TT for large goiters give no advantage or disadvantage to the surgeon. The only "major disadvantage" is the discomfort for the patient. Inversely, drains probably influence surgeons' serenity,especially when c TT is performed in nonspecialized departments.

关键词： total thyroidectomy Drains Postoperative complications Postoperative hemorrhage Discomfort

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Post thyroidectomy Assessment of Intact Parathyroid Hormone for Early Prediction of Hypocalcaemia

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第2期13卷 71-84页

作者： Md. Masum Billah Ripon Kumar Sarkar Md. Yousuf Ali Saad Zaman Md. Nazmul Hasan Md. Shehab Uddin Md. Mosleh Uddin Kazi Shameemus Salam Farzana Binte Abedin Leera Department of Otolaryngology-Head & Neck Surgery Universal Medical College Hospital Dhaka Bangladesh Department of Otolaryngology-Head & Neck Surgery National Institute of Ear Nose and Throat Dhaka Bangladesh Shaheed Ahsan Ullah Master General Hospital Gazipur Bangladesh Department of Otolaryngology-Head & Neck Surgery Cumilla Medical College Cumilla Bangladesh Department of ENT Oncology National Institute of Cancer Research & Hospital Dhaka Bangladesh Department of ENT Outdoor Rajshahi Medical College Hospital Rajshahi Bangladesh Department of Otolaryngology-Head & Neck Surgery Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh Department of Biochemistry Delta Medical College Hospital Dhaka Bangladesh

Background: As the half-life of intact parathyroid hormone (iPTH) is very low, it reflects parathyroid insufficiency within minutes to hours after total thyroidectomy. Therefore, iPTH level assessment in the postoperative period can be used to predict the development of hypocalcaemia. The optimal time point to measure serum iPTH is important for the accurate prediction of hypocalcaemia. Aim: This paper aims to evaluate the ability of iPTH as an early predictive marker of hypocalcaemia and determine which time iPTH is more able to predict postoperative hypocalcaemia. Method: This prospective observational study was conducted in the Department of Otolaryngology-Head & Neck Surgery, BSMMU, Dhaka, from July 2020 to December 2021, with 67 patients who underwent total thyroidectomy. iPTH levels were measured on the day before the operation and at 1 hour, 4 hours, and 24 hours after the operation. *** levels were measured on the day before the operation and 1st postoperative day. All the data were compiled and sorted properly and were analyzed statistically. Results: Postoperative hypocalcaemia developed in 18 cases, with an incidence of 26.9%. Pearson correlation showed a significant correlation between postoperative iPTH at 1 hr, 4 h, and 24 hr with 1st postoperative calcium value. The Receiver operating characteristic (ROC) curve was processed for the postoperative iPTH at 1 hr, 4 h, and 24 hr. The sensitivity, specificity, cut-off value, and mean AUC found 93.9%, 94.4%, ≤14.0, 0.988;95.9%, 94.4%, ≤09.5, 0.993 and 91.8%, 94.4%, ≤11.0, 0.993 respectively. Conclusion: iPTH can be used as an early predictor of post-thy-roidectomy hypocalcaemia. 4 hr iPTH showed more sensitivity and specificity for a cut-off value near the laboratory reference range.

关键词： total thyroidectomy Hypocalcaemia Serum Intact Parathyroid Hormone Early Predictor of Hypocalcaemia

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Completion thyroidectomy:is timing important for transcervical and remote access approaches?

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2020年第3期6卷 165-170页

作者： Juan Pablo Duenas Carlos Simon Duque Laura Cristancho Manuela Mendez Hospital Pablo Tobon Uribe Instituto de Cancerologia IDC Las AmericasClfnica Universitaria BolivarianaClinica el Rosario Sede el Tesoro(CLID)MedellinColombia Universidad Militor Nueva Granada BogotaDCColombia Universidad CES MedellinColombia Hospital Pablo Tobon Uribe Clfnica Las AmericasMedellinColombia

Completion thyroidectomy(CT)is employed after lobectomy when histopathological results mandates total removal of the gland as in case of well differentiated thyroid carcinoma(DTC).It is also employed as a second stage thyroid surgery when unfavorable events occur as in recurrent laryngeal nerve injury or when the surgeon finds out the case is beyond his/her expertise in an attempt to protect the contralateral side and allowing time for recovery or for an expert surgeon to help.

关键词： Completion thyroidectomy total thyroidectomy Complications Nerve monitoring

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