Complications and risk factors related to the extent of surgery in thyroidectomy. Results from 2,043 procedures.
Stavros N. Karamanakos,Kostas B. Markou,Konstantinos Panagopoulos,Dionisios Karavias,Constantinos E. Vagianos,Chrisoula D. Scopa,Vassiliki Fotopoulou,Anna Liava,Konstantinos Vagenas +8 more
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TLDR
Despite the higher morbidity, total thyroidectomy is emerging as an attractive surgical option even for benign thyroid disease due to the risk of subclinical (occult) malignancy, the possibility of goiter relapse as well as of the increased risk of complications following reoperation.Citations
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Recurrent laryngeal nerve injury in thyroid surgery: a review
TL;DR: The current literature and data confirm that patients undergoing re‐operative thyroid surgery and thyroid surgery for malignancies are at increased risk of RLNP, and intraoperative visualization and capsular dissection of the RLN remain the gold standard for intraoperative care during thyroid surgery.
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Hypoparathyroidism after total thyroidectomy: incidence and resolution.
TL;DR: Most patients with a low postoperative PTH recover function quickly, but it can take up to 1 y for full resolution, so hypoparathyroidism needs to be defined not only by PTH levels but also by medication requirements.
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Epidemiology of vocal fold paralyses after total thyroidectomy for well-differentiated thyroid cancer in a Medicare population.
David O. Francis,Elizabeth C. Pearce,Shenghua Ni,C. Gaelyn Garrett,David F. Penson,David F. Penson +5 more
TL;DR: Annual rates of postthyroidectomy vocal fold paralyses are decreasing among Medicare beneficiaries with WDTC, and high incidence in this aged population is likely due to a preponderance of temporary paralyses, which is supported by the need for directed intervention in less than a quarter of affected patients.
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Neuromonitoring in thyroidectomy: a meta-analysis of effectiveness from randomized controlled trials.
Alvaro Sanabria,Adonis Ramírez,Luiz Paulo Kowalski,Carl E. Silver,Ashok R. Shaha,Randall P. Owen,Carlos Suárez,Avi Khafif,Alessandra Rinaldo,Alfio Ferlito +9 more
TL;DR: Meta-analysis of the combined results of individual studies to measure the frequency of RLN and EBSLN injuries in patients who underwent thyroidectomy with routine neuromonitoring did not demonstrate a statistically significant decrease in the risk of temporary or definitive RLN injury and definitive EBS laryngeal nerve injury with the use of neuromonitorsing.
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IONM-guided goiter surgery leading to two-stage thyroidectomy—indication and results
TL;DR: A significant difference in the rate of bilateral RLNP is shown when comparing termination and continuation of a bilateral procedure after primary IONM signal loss, which strongly recommends a two-stage thyroidectomy after signal loss on the primary side of resection in benign bilateral goiter surgery.
References
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The spectrum of thyroid disease in a community: the whickham survey
W.M.G. Tunbridge,D. C. Evered,Reginald Hall,D. Appleton,M Brewis,F. Clark,J G Evans,E. T. Young,T. Bird,P. A. Smith +9 more
TL;DR: TSH levels above 6 mu/1 were shown to reflect a significant lowering of circulating thyroxine levels and showed a strong association with thyroid antibodies in both sexes, independent of age.
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Risk factors of paralysis and functional outcome after recurrent laryngeal nerve monitoring in thyroid surgery.
Henning Dralle,Carsten Sekulla,Johannes Haerting,Wolfgang Timmermann,Hans Jürgen Neumann,Eberhard Kruse,Stefan Grond,Hans Peter Mühlig,Christian Richter,Johannes Voss,Oliver Thomusch,Hans Lippert,Ingo Gastinger,Michael Brauckhoff,Oliver Gimm +14 more
TL;DR: Visual nerve identification was identified to be the gold standard of RLN treatment in thyroid surgery because of the overall low frequency of RLNP and no statistical difference compared with visual nerve identification only was reached in the setting of this study.
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Multivariate analysis of risk factors for postoperative complications in benign goiter surgery: prospective multicenter study in Germany.
O. Thomusch,Andreas Machens,Carsten Sekulla,Jörg Ukkat,Hans Lippert,Ingo Gastinger,Henning Dralle +6 more
TL;DR: The multivariate analyses clearly confirmed the pivotal role of routine RLN identification, independent of the extent of the thyroid resection, and might help hospitals with lower operative volumes to identify patients at increased risk whom they might consider for specialist care.
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The impact of surgical technique on postoperative hypoparathyroidism in bilateral thyroid surgery: A multivariate analysis of 5846 consecutive patients
Oliver Thomusch,Andreas Machens,Carsten Sekulla,Jörg Ukkat,Michael Brauckhoff,Henning Dralle +5 more
TL;DR: Extent of resection and surgical technique had a greater impact on the rates of permanent postoperative hypoparathyroidism than thyroid pathologic condition.
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Complications of Thyroid Surgery: How to Avoid Them, How to Manage Them, and Observations on Their Possible Effect on the Whole Patient
TL;DR: The surgeon performing thyroidectomy unless the surgeon performing it is well trained in operative surgery and is knowledgeable of the gland and its function, pathology, and anatomy, excellent results cannot be achieved.