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    Tytuł:
    Total Thyroidectomy for Multinodular Goiter. Possibility of Implementation in a District Hospital
    Autorzy:
    Cichoń, Wojciech
    Walencik, Grzegorz
    Gierczak, Wojciech
    Aksędowski, Krzysztof
    Bucki, Jerzy
    Cichoń, Stanisław
    Powiązania:
    https://bibliotekanauki.pl/articles/1396038.pdf
    Data publikacji:
    2013-02-01
    Wydawca:
    Index Copernicus International
    Tematy:
    thyroid
    total
    thyroidectomy
    multinodular
    goiter
    Opis:
    Increasing number of surgical subspecialities causes general surgeons have little experience with more complex procedures as total thyroidectomy. The aim of the study was to present the outcome of total thyroidectomy following its implementation in a district hospital where such procedure has not been performed previously. Material and methods. 293 patients were operated on for goiter between 01.10.2008 and 30.09.2011 in the District Hospital in Proszowice by one contracted endocrine surgeon. Hemithyroidectomy was performed in 75 (23.7%) patients and total thyroidectomy in 191 (76.3%) patients for multinodular goiter and only the latter group was subjected for further analysis. Results. There were no bilateral recurrent laryngeal nerve palsy. A unilateral transient recurrent laryngeal nerve palsy occured in 6 patients (3.1%; 1.5% per risk) and postoperative hypocalcemia in 29 (15.7%) patients. 2 (1%) patients required wound revision due to a postoperative bleeding. Postoperative pathology revealed in 12 (6.2%) patients differentiated thyroid cancer. Conclusions. 1. Total thyroidectomy in a district hospital is still a safe way to operate on thyroid for nonmalignant disorders with low number of complications. 2. Total thyroidectomy is a definite surgical treatment in patients diagnosed by postoperative pathology with differentiated thyroid cancer.
    Źródło:
    Polish Journal of Surgery; 2013, 85, 2; 53-57
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Usefulness of electrosurgical techniques in thyroid gland surgery
    Autorzy:
    Kowalski, Bartosz
    Bierca, Jacek
    Zmora, Jan
    Kołodziejczak, Małgorzata
    Kosim, Anna
    Frączek, Mariusz
    Powiązania:
    https://bibliotekanauki.pl/articles/1394593.pdf
    Data publikacji:
    2012
    Wydawca:
    Index Copernicus International
    Tematy:
    thyroidectomy
    Thermostapler®
    bipolar coagulation
    Opis:
    Wide propagation of new generation of electrosurgical devices such as bipolar vessel sealing systems (eg. Thermostapler® by EMED) enabled seamless closing of blood vessels with a diameter up to 7 mm while maintaining the necessary safety margin, as well as reducing the duration of the operation. We decided to verify these reports in our material. Aim of the study was comparison of thyroid surgery performed with the electrocautery tool – Thermostapler® by EMED with surgery using classic hemostasis technique to evaluate the operative time and complications in the form of bleeding, recurrent laryngeal nerve paralysis, symptoms of hypoparathyroidism, and wound infection. Material and methods. We retrospectively analyzed 256 patients operated in the Department of General and Proctological Surgery Solec Hospital in Warsaw due to inert thyroid goitre. All patients underwent total thyroidectomy. Patients were divided into two groups. The first group consisted of 126 patients operated in 2000, using classic techniques of hemostasis. While the second group consisted of 130 patients operated in 2007-2008 with Thermostapler®. We compared duration of surgery and the incidence of postoperative complications. Results. The operative time was significantly shorter (average 18 minutes) in the second group of patients. We also recorded a statistically significant decrease in the incidence of complications in the group operated with Thermostapler. conclusions. Use of bipolar vessel sealing system in a decisive manner shortens the duration of operation. Use of bipolar vessel sealing system also enables a radical reduction in the incidence of complications rate such as bleeding, recurrent laryngeal nerve paralysis, symptoms of hypoparathyroidism, and wound infection. In the future, similar studies should be performed to assess the real costs resulting from the use Thermostapler®
    Źródło:
    Polish Journal of Surgery; 2012, 84, 5; 225-229
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Analysis of factors affecting the development of hypocalcaemia after multinodular goitre surgery
    Autorzy:
    Papaj, Piotr
    Kozieł, Sławomir
    Mrowiec, Sławomir
    Powiązania:
    https://bibliotekanauki.pl/articles/1393196.pdf
    Data publikacji:
    2017
    Wydawca:
    Index Copernicus International
    Tematy:
    thyroidectomy
    hypocalcemia
    calcium
    TSH
    multinodular goiter
    Opis:
    Introduction: Thyroidectomy is a common surgery performed especially in treatment of multinodular goitre. The most common post-thyroidectomy complication is a postoperative hypocalcaemia, and the percentage of postoperative hypoparathyroidism could reach even 50%. Tested group and methods: A forward-looking, randomized testing was done on a group of 113 women being subject to multinodular goitre surgery. In this article, we wish to present an analysis of the results obtained in the control group, focusing on the predicative factors which determine the development of postoperative hypocalcaemia. Obtained results: The rate of postoperative biochemical hypocalcaemia development was significantly higher in the group of patients, where the preoperative calcium concentration was lower than 2,4 mmol/l. In that group, the development of biochemical hypocalcaemia was observed in 93,7% of cases (30 out of 32 patients), in comparison with 65,3% (17 out of 26) in the group of higher preoperative concentration of calcium. The highest risk of occurrence of postoperative hypocalcaemia was borne by the total thyroidectomy, while the lowest one by the subtotal thyroid lobectomy of one lobe only. Conclusions: A higher preoperative concentration of calcium in blood serum is related to the lower rate of occurrence of postoperative biochemical hypocalcaemia. However, no such correlation was revealed in the case of postoperative symptomatic hypocalcaemia. Lack of correlation was determined between the preoperative concentration of TSH and FT4 in blood serum and the rate of occurrence of postoperative hypocalcaemia, both symptomatic and asymptomatic. The performed statistics did not reveal a relation between the postoperative hypocalcaemia and the duration of the surgery, but a significant correlation was stated with the scope of the performed surgery. Revealing a relation between the rate of occurrence of postoperative hypocalcaemia and the experience of the surgeon performing the surgery was not successful.
    Źródło:
    Polish Journal of Surgery; 2017, 89, 2; 26-30
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Cervical thyroid remnant consistent with papillary carcinoma as an incidental finding in a patient with benign total thyroidectomy ten years prior
    Autorzy:
    Ruano Campos, Adriana
    Rivera Alonso, Daniel
    Ochagavía Cámara, Santiago
    Powiązania:
    https://bibliotekanauki.pl/articles/1391852.pdf
    Data publikacji:
    2020
    Wydawca:
    Index Copernicus International
    Tematy:
    benign thyroidectomy
    cervical thyroid remnant
    papillary thyroid carcinoma
    Opis:
    Background: Differential diagnosis of a cervical lesion corresponding with papillary thyroid carcinoma (PTC) after benign total thyroidectomy can be a real challenge. Methods: A cervical thyroid remnant compatible with papillary carcinoma was incidentally found ten years after total thyroidectomy for a non-functional multinodular goitre. Histological analysis of fine needle puncture aspiration (FNPA) was highly suggestive for PTC. Surgical excision of the cervical lesion was performed. Specimen study demonstrated a classic variant of PTC contacting a peripheral margin, applying ablative treatment with radioactive iodine postoperatively. Results: The patient did not present signs of recurrence during follow-up. Small thyroid remnants after benign thyroidectomy are often left behind, although their risk of malignancy is exceptional. Conclusions: It is important to individualize therapeutic approach when facing this rare entity. We decided to treat the patient by removing the lesion followed by ablation therapy with successful results. PTC: Papillary thyroid carcinoma FNPA: Fine needle puncture aspiration
    Źródło:
    Polish Journal of Surgery; 2020, 92, 1; 52-54
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Perioperative calcium and vitamin D supplementation in patients undergoing thyroidectomy – literature review
    Autorzy:
    Grzegory, Anna
    Pomorski, Lech
    Powiązania:
    https://bibliotekanauki.pl/articles/1392434.pdf
    Data publikacji:
    2018
    Wydawca:
    Index Copernicus International
    Tematy:
    hypocalcemia
    hypoparathyroidism
    calcium
    vitamin D
    thyroidectomy
    perioperative period
    Opis:
    Introduction: Postoperative hypocalcemia is a narrow but significant problem for patients undergoing thyroid and parathyroid surgery. It is the most common complication after thyroidectomy. It is associated with transient or permanent hypoparathyroidism. It could potentially be life-threatening for patients and increases the costs of hospitalization. The aim of the study was to evaluate the results of studies that routinely administrated calcium and/or vitamin D during the postoperative period. Materials and Methods: In this article, a literature review – 15 studies that used routine perioperative calcium (7 studies), vitamin D (2 studies) and calcium with vitamin D (11 studies) supplementation was performed. Supplementation effectiveness in prevention of postoperative hypocalcemia was compared to no prophylaxis in 10 studies. Five studies compared the effect of combined administration (calcium and vitamin D) to calcium alone. The number of papers dealing with this problem is not particularly high. Results: Supplementation significantly decreased the rate of laboratory and symptomatic hypocalcemia. It was also effective in reducing the severity of symptoms. The combination of calcium with vitamin D was the most effective strategy. No hypercalcemia or parathyroid hormone inhibition was observed in the supplemented groups. Routine supplementation was less expensive than performing laboratory tests in the course of treatment of hypocalcemia. Conclusions: The results of analyzed studies showed the clinical and economic advantage of routine perioperative prophylactic supplementation of vitamin D and/or calcium as compared to no prophylaxis. However, the majority of studies showed a significant range of variability in patients’ characteristics. Numerous studies did not evaluate the preoperative 25-hydroxycholecalciferol level – a risk factor for postoperative hypocalcemia. Discussion: The use of routine prophylactic supplementation of calcium and vitamin D in the perioperative period can be useful in everyday clinical practice. Further research is needed to draw clear guidelines regarding prophylactic calcium and vitamin D therapy for patients after thyroidectomy.
    Źródło:
    Polish Journal of Surgery; 2018, 90, 4; 46-50
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Preparation of patients submitted to thyroidectomy with oral glucose solutions
    Autorzy:
    Lubiszewski, Michał
    Drozda, Rafał
    Śmigielski, Janusz
    Kuzdak, Krzysztof
    Kołomecki, Krzysztof
    Powiązania:
    https://bibliotekanauki.pl/articles/1394599.pdf
    Data publikacji:
    2012
    Wydawca:
    Index Copernicus International
    Tematy:
    postoperative insulin-resistance
    thyroidectomy
    response to injury
    Opis:
    The aim of the study was to determine postoperative insulin-resistance in patients subject to total thyroidectomy, the prevalence of subjective feelings of hunger immediately before surgery, and the incidence of nausea/ vomiting after surgery in patients prepared for elective operations by means of oral glucose solutions. Material and methods. The study group comprised 115 patients, including 71 patients prepared for surgery by means of oral glucose solutions (12.5% glucose) administered 12 and 3 hours before the procedure, at a dose of 800 and 400 ml. The control group comprised 44 patients prepared for surgery by means of the traditional manner- the last meal was served before 2pm the day before the surgical procedure, while fluids before 10pm. Considering both groups, we evaluated glucose and insulin levels three times, as well as determined the insulin-resistance ratio (HOMA-IR) 24 before, and 12 hours and 7 days after surgery. The incidence of nausea and vomiting after surgery, and the subjective feeling of hunger before surgery were also evaluated. Results. Statistically significant differences considering insulin level and HOMA-IR values were observed during the II and III measurements. The glucose and insulin values, and the HOMA-IR insulinresistance ratio, showed no statistically significant differences during measurement I. No statistically significant glucose level differences were observed during measurements II and III. A significantly greater subjective feeling of hunger before surgery and nausea/vomiting afterwards were observed in the control group. Conclusions. The preparation of patients with oral glucose solutions decreases the incidence of postoperative (thyroidectomy) insulin-resistance, and occurrence of nausea/vomiting during the postoperative period.
    Źródło:
    Polish Journal of Surgery; 2012, 84, 5; 253-257
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    One-Day Thyroid Surgery – Is it Safe?
    Autorzy:
    Wieloch, Maria
    Koza, Piotr
    Kuzdak, Krzysztof
    Ziemniak, Piotr
    Kołomecki, Krzysztof
    Powiązania:
    https://bibliotekanauki.pl/articles/1396277.pdf
    Data publikacji:
    2013-06-01
    Wydawca:
    Index Copernicus International
    Tematy:
    thyroidectomy
    one-day surgery
    postoperative bleeding
    tetany
    Opis:
    was to evaluate the safety of one-day thyroid surgery based on the assessment of the incidence of early postoperative complications. Material and methods. The study comprised 726 patients who underwent total thyroidectomy during the period between January, 2012 and February, 2013. The study considered the three most common thyroidectomy complications. Results. In the group of 726 patients, recurrent laryngeal nerve paralysis was observed in 22 cases, accounting for 3.07% of all patients. Postoperative bleeding was observed in 12 cases (1.65%). In 8 cases, bleeding occurred during the first 8 hours after surgery, while in the remaining four cases- 9, 12, 18, and 26 hours after surgery. The study group was divided into three subgroups, in which the concentrations of calcium and parathyroid hormone, 6 hours and 20 hours after surgery, were determined. In the first group (223 patients), only the parathyroid hormone level was determined. The decreased PTH level was associated with the appearance of tetany symptoms in 15% of cases. Amongst patients in whom the parathyroid hormone level was normal, tetany symptoms were observed in 0.5% of cases. In the second group (256 patients), only the serum calcium level was determined. Amongst patients with normal serum calcium levels, 1% of cases presented with tetany symptoms. In patients where the serum calcium level was reduced, tetany symptoms appeared in 35% of cases. In the third group (247 patients), both serum calcium and parathyroid hormone levels were determined. In the group of patients with normal, both serum calcium and parathyroid hormone levels, tetany symptoms were not observed. Amongst patients with normal serum calcium levels and decreased PTH levels on the day of surgery, tetany symptoms were observed in 25% of cases, while during the first postoperative day-37% of cases. Conclusion. One-day thyroid surgery, due to the appearance of complications cannot be regarded as a completely safe procedure.
    Źródło:
    Polish Journal of Surgery; 2013, 85, 6; 317-322
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Early predictors of post – thyroidectomy hypoparathyroidism
    Autorzy:
    Sieniawski, Karol
    Kaczka, Krzysztof
    Paduszyńska, Katarzyna
    Fendler, Wojciech
    Tomasik, Bartłomiej
    Pomorski, Lech
    Powiązania:
    https://bibliotekanauki.pl/articles/1393727.pdf
    Data publikacji:
    2016
    Wydawca:
    Index Copernicus International
    Tematy:
    hypoparathyroidism
    thyroid surgery
    total thyroidectomy
    intact PTH assay
    hypocalcemia
    Opis:
    Thyroid surgery is the most commonly performed procedure in the field of endocrine surgery. Studies are still ongoing on the development of a single algorithm for diagnosis and care of patients at risk of postoperative hypoparathyroidism. The aim of the study was to determine the biochemical marker that would allow the most accurate diagnosis of patient groups at risk of developing hypoparathyroidism and to identify risk factors for this disorder. Material and methods. The prospective study included 142 consecutive patients undergoing total thyroidectomy for benign goiter from January 1st 2014 to December 31st 2015. Serum intact parathyroid hormone (iPTH), total calcium (Ca), phosphate (P), and magnesium (Mg) levels have been measured preoperatively and at 1, 6, 24, and 48 h postoperatively. Results. Clinical symptoms of hypoparathyroidism developed in 25 (17.6%) of 142 patients. The best diagnostic accuracy for hypoparathyroidism based on ROC curves was obtained for iPTH at 6h (AUC 0.942; 95% CI: 0.866-1.000, p<0.001) and its percentage change from baseline ΔiPTH at 6h (AUC 0.930; 95% CI: 0.858-1.000, p<0.001). In an multivariate analysis, the preoperative Ca level higher by 0.1 mmol/l, and iPTH level higher by 0.1 pmol/l were associated with a lower risk of hypoparathyroidism, by 68% (p=0.012) and 61% (p=0.007), respectively. A 1% decline in iPTH from baseline increased the risk of hypoparathyroidism by 15% (p<0.001). Conclusions. The most reliable markers indicating a high risk of postoperative hypoparathyroidism are the decline in ΔiPTH at 6h by > 65% or iPTH level at 6h <1.57 pmol /l. A postoperative decline in iPTH levels is an independent risk factor for the development of hypoparathyroidism. Preoperative higher concentrations of Ca and iPTH are protective factors for the development of this disorder.
    Źródło:
    Polish Journal of Surgery; 2016, 88, 6; 540-555
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Endoscopic treatment of oesophageal injury after thyroidectomy – a case report
    Autorzy:
    Radziuk, Dagmara
    Witzling, Mieczysław
    Powiązania:
    https://bibliotekanauki.pl/articles/1392110.pdf
    Data publikacji:
    2019
    Wydawca:
    Index Copernicus International
    Tematy:
    cervical oesophageal perforation
    oesophageal injury
    oesophagogastroscopy
    oesophagus dilation
    thyroidectomy
    Opis:
    The most common complications after thyroidectomy are postoperative neck hematoma, recurrent laryngeal nerve injury and hypoparathyroidism [1]. However, iatrogenic cervical esophageal perforation is a very rare repercussion of this procedure. In literature there are a few reported cases concerning this complication. We want to report a case of a patient with severe esophageal injury resulting from thyroidectomy.
    Źródło:
    Polish Journal of Surgery; 2019, 91, 6; 50-52
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Impact of the laryngeal nerves anatomy on the intraoperative neuromonitoring results in surgery of thyroid gland and functional results after partial laryngectomies
    Autorzy:
    Berger, Greta
    Kosztyła - Hojna, Bożena
    Chyczewski, Lech
    Powiązania:
    https://bibliotekanauki.pl/articles/1392222.pdf
    Data publikacji:
    2019
    Wydawca:
    Index Copernicus International
    Tematy:
    recurrent laryngeal nerve (RLN)
    superior laryngeal nerve (SLN)
    thyroidectomy
    partial laryngectomy
    neuromonitoring
    Opis:
    The aim of this work was to describe, interpret and highlight the impact of neuroanatomy in the region of the larynx on intraoperative neuromonitoring (IONM) during thyroidectomy. A rich network of anastomoses of the recurrent laryngeal nerve (RLN) and superior laryngeal nerve (SLN) may have impact on the results of thyroidectomy and partial laryngectomy. Intraoperative neuromonitoring is a useful tool in the armamentarium of a head and neck surgeon but it will never replace profound knowledge of surgical anatomy and good surgical technique.
    Źródło:
    Polish Journal of Surgery; 2019, 91, 2; 30-37
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
      Wyświetlanie 1-10 z 10

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