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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:
Glove failure in elective thyroid surgery: A prospective randomized study
Autorzy:
Timler, Dariusz
Kusiński, Michał
Iltchev, Petre
Szarpak, Łukasz
Śliwczyński, Andrzej
Kuzdak, Krzysztof
Marczak, Michał
Powiązania:
https://bibliotekanauki.pl/articles/2177242.pdf
Data publikacji:
2015-04-02
Wydawca:
Instytut Medycyny Pracy im. prof. dra Jerzego Nofera w Łodzi
Tematy:
thyroidectomy
surgical gloves
surgeon
glove failure
elective surgery
thyroid surgery
Opis:
Objectives To analyze perforation rate in sterile gloves used by surgeons in the operating theatre of the Department of Endocrinological and General Surgery of Medical University of Lodz. Material and Methods Randomized and controlled trial. This study analyses the incidents of tears in sterile surgical gloves used by surgeons during operations on 3 types of thyroid diseases according to the 10th revision of International Statistical Classification of Diseases and Related Health Problems (ICD-10) codes. Nine hundred seventy-two pairs (sets) of gloves were collected from 321 surgical procedures. All gloves were tested immediately following surgery using the water leak test (EN455-1) to detect leakage. Results Glove perforation was detected in 89 of 972 glove sets (9.2%). Statistically relevant more often glove tears occurred in operator than the 1st assistant (p < 0.001). The sites of perforation were localized mostly on the middle finger of the non-dominant hand (22.5%), and the non-dominant ring finger (17.9%). Conclusions This study has proved that the role performed by the surgeon during the procedure (operator, 1st assistant) has significant influence on the risk of glove perforations. Nearly 90% of glove perforations are unnoticed during surgery.
Źródło:
International Journal of Occupational Medicine and Environmental Health; 2015, 28, 3; 499-505
1232-1087
1896-494X
Pojawia się w:
International Journal of Occupational Medicine and Environmental Health
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Correlation of fine needle aspiration cytology with histopathology in patients undergoing thyroid surgery
Autorzy:
Singh, Parampreet
Gupta, Nitin
Dass, Arjun
Handa, Uma
Singhal, Surinder
Powiązania:
https://bibliotekanauki.pl/articles/1397291.pdf
Data publikacji:
2021
Wydawca:
Index Copernicus International
Tematy:
FNAC
histopathology
thyroid swelling
Opis:
Introduction: Thyroid swellings are one of the most common swellings in the neck. They pose a major problem in developing countries like India, considering the high endemicity for iodine deficiency disorders. Thyroid gland is affected in many conditions. Out of these, majority are benign while less than 5% are malignant. Multiple noninvasive and invasive diagnostic tests are available for the diagnosis of thyroid swelling. However, at present, FNAC is considered the gold standard investigation. Despite the high sensitivity and specificity, FNAC has its limitations. Histopathological examination of surgically excised thyroid swelling is the confirmatory gold standard to determine the pathology of the thyroid gland. Material and method: This prospective and observational study was conducted in the Department of Otorhinolaryngology (ENT) in collaboration with the Department of Pathology in a tertiary care hospital and medical school. A total of seventy patients were included. Results: The diagnosis on FNAC was correlated with histopathology. Statistical analysis showed FNAC had a sensitivity of 83.3%, specificity of 100%, positive predictive value of 100%, negative predictive value of 96.7%. However, the overall accuracy in this study was determined to be 95.71%. Results were found to be statistically significant (P < 0.05). Conclusions: The diagnostic role of FNAC in thyroid lesions is of utmost importance in making preoperative diagnosis. FNAC was found to be highly sensitive and specific for diagnosing thyroid lesions but the final HPE is considered as a gold standard.
Źródło:
Polish Journal of Otolaryngology; 2021, 75, 4; 33-39
0030-6657
2300-8423
Pojawia się w:
Polish Journal of Otolaryngology
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Clinical and Metabolic Changes Following Complicated Thyroid Resection Procedures
Autorzy:
Sławeta, Norbert
Głuszek, Stanisław
Heciak, Jacek
Powiązania:
https://bibliotekanauki.pl/articles/1396347.pdf
Data publikacji:
2013-05-01
Wydawca:
Index Copernicus International
Tematy:
thyroid surgery
thyroid surgery complications
hypoparathyroidism
vocal cord paralysis
Opis:
Clinical and metabolic consequences of complicated thyroid resection procedures are rarely an object of complex analysis, and teams participating in treatment may have a very limited knowledge of them. The aim of the study was to assess clinical and metabolic consequences of complicated thyroid surgical procedures. Material and methods. In the years 2002-2007, 756 patients underwent surgery due to non-neoplastic thyroid diseases. Sixty-nine (9.1%) patients experienced complications manifesting as vocal cord paralysis and/or hypoparathyroidism. Follow-up examination was conducted in a group of 42 persons, which amounted to 61% of patients who experienced complications following thyroid surgical procedures. Follow-up examination, comprising assessment of morphotic blood elements, electrolyte, lipid and parathormone blood concentrations, thyroid hormone activity, respiratory function, vocal cord mobility, bone mineralization and ultrasound examination of the pocket left after thyroid resection, was conducted after the mean period of 43 months following surgery. Results. In the analyzed group, no significant differences in plasma electrolyte content were found (sodium, potassium, magnesium, calcium and phosphorus ions). In the group of patients with chronic hypoparathyroidism, no hypophosphatemia was observed, and there were no reports of concomitant nephrolithiasis or cataract. Increased cholesterol concentration was observed in the group of patients with chronic hypoparathyroidism and without hypoparathyroidism (p = 0.07). In 35% of patients with chronic vocal cord paralysis, abnormal results of spirometry tests were obtained. In the group of patients with chronic hypoparathyroidism, densitometry examination revealed higher T-score values compared with patients with transient hypoparathyroidism and vocal cord paralysis (p = 0.07). No bone mineralization disorders manifesting as pathological fractures were noted. Conclusions. The knowledge of clinical and metabolic consequences of complicated thyroid surgical procedures, due to their complexity, may be very limited among the members of both surgical teams and teams involved in management of complications. Development of a complication following thyroid surgery may be associated with significant homeostasis disorders, especially as regards calcium-phosphate metabolism, the skeletal system and the respiratory system. Such disorders can manifest long after the disease onset, only properly intensified and long-term management allows limitation of their extent.
Źródło:
Polish Journal of Surgery; 2013, 85, 5; 235-246
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Evaluation of the Learning Curve for Intraoperative Neural Monitoring of the Recurrent Laryngeal Nerves in Thyroid Surgery
Autorzy:
Pragacz, Krzysztof
Barczyński, Marcin
Powiązania:
https://bibliotekanauki.pl/articles/1396001.pdf
Data publikacji:
2015-03-01
Wydawca:
Index Copernicus International
Tematy:
thyroid surgery
intraoperative neuromonitoring
recurrent laryngeal nerve
Opis:
Intraoperative neuromonitoring facilitates identification of the recurrent laryngeal nerves (RLN) and allows for predicting their postoperative function. Nevertheless, the outcome of thyroid surgery monitoring is affected by both the experience of the operator and his mastering of the technique. The aim of the study was the assessment of the learning curve for intraoperative RLN neuromonitoring. Material and methods. The prospective analysis included 100 consecutive thyroid operations performed by a single surgeon during implementation of RLN neuromonitoring in a district surgical ward in Staszów. RLN neuromonitoring was performed in keeping with the recommendations of the International Neural Monitoring Study Group using a C2 NerveMonitor (Inomed, Germany). The outcomes of initial 50 procedures (group I: 08/2012-07/2013) were compared with the results of subsequent 50 operations (group II: 08/2013-07/2014). The evaluation included demographic and intraoperative data along with predictive value of the method and complications. Results. In group II as compared to group I, a significant reduction of operative time was noted (102.1±19.4 vs 109.9±19; p=0.045), along with an increased percentage of identified RLNs (99% vs 89.2%; p=0.006), a decreased percentage of correction-requiring technical errors (8% vs 24%; p=0.029), an improved negative predictive (99% vs 89.3%; p<0.001) and positive value (75% vs 55.6%; p<0.001), as well as a decreased percentage of RLN injuries (3% vs 14%; p=0.006). Conclusions. Mastering the technique of intraoperative RLN neuromonitoring in thyroid surgery requires the surgeon to perform independently approximately 50 monitored procedures, what allows for achieving the predictive value of the method that is comparable to outcomes published by referral centers.
Źródło:
Polish Journal of Surgery; 2014, 86, 12; 584-593
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:
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:
Pielęgniarska ocena wpływu operacji tarczycy na poziom wapnia u pacjentów po wykonanym zabiegu
Nursing assessment of the impact of thyroid surgery on calcium levels in postoperative patients
Autorzy:
Małecka, Beata
Wojciechowska, Wioletta
Zielińska, Ewelina
Powiązania:
https://bibliotekanauki.pl/articles/20434375.pdf
Data publikacji:
2021-03-28
Wydawca:
Państwowa Akademia Nauk Stosowanych we Włocławku
Tematy:
nursing assessment
thyroid gland
surgical procedures
calcium
ocena pielęgniarska
tarczyca
zabiegi operacyjne
wapń
Opis:
Wstęp. Choroby tarczycy dotyczą około 20% Polaków, częściej schorzenie to występuje u kobiet niż mężczyzn. W skali roku w Polsce wykonuje się około 20 tysięcy zabiegów tego typu. Zabieg operacyjny jest sytuacją bardzo trudną dla każdego pacjenta. Wiąże się z tym odczuwanie lęku i niepokoju. Pielęgniarka to osoba, która ma bezpośredni i najczęstszy kontakt z pacjentem. Jest w stanie wykryć zaistniałe nieprawidłowości, co pozwala na szybką reakcję i podjęcie odpowiednich działań. Cel. Celem badań była analiza różnicy poziomu wapnia przed i po zabiegu operacyjnym tarczycy. Materiał i metody. Do przeprowadzenia badań wykorzystano metodę analizy dokumentacji. Przeanalizowana dokumentacja medyczna dotyczyła 100 pacjentów po tyreoidektomii. Uzyskane wyniki badań poddano analizie statystycznej testem χ2 dla prób niezależnych. Materiał badawczy podzielono na 5 obszarów: występowanie spadku wapnia po zabiegu operacji tarczycy, objawy towarzyszące w przypadku spadku wapnia, występowanie objawów tężyczki po zabiegu operacyjny, leczenie preparatami wapnia po operacji usunięcia tarczycy oraz wpływu poziomu wapnia na czas hospitalizacji. Wyniki. W obszarze występowania spadku wapnia po operacji tarczycy zaobserwowano znaczny spadek. W obszarze objawów jakie pojawiły się podczas spadku wapnia zauważono, że 86% operowanych nie odczuwało żadnych objawów towarzyszących spadkowi wapnia. W analizie obszaru występowania objawów tężyczki po zabiegu wśród 72% pacjentów nie wystąpiły powikłania pooperacyjne. W obszarze leczenie preparatami wapnia 25% osób wymagało suplementacji wapnia po zabiegu operacyjnym, natomiast 75% nie wymagało suplementacji wapnia. W obszarze wpływu poziomu wapnia na czas hospitalizacji większość chorych, bo 74 % była hospitalizowana po zabiegu operacyjnym mniej niż 5 dni. Wnioski. 1. Po tyreoidektomii zaobserwowano niższe poziomy wapnia. 2. Wystąpienie hipokalcemii charakteryzuję się przede wszystkim uczuciem mrowienia w okolicy ust, rąk oraz skurczem mięśni i drętwieniem kończyn. 3. Pomimo spadku wapnia nie u wszystkich pacjentów po operacji występują z tego powodu objawy. 4. Suplementacji preparatami wapnia wymaga tylko część pacjentów operowanych. 5. Wraz ze spadkiem poziomu wapnia wydłuża się czas hospitalizacji po zabiegu usunięcia gruczołu tarczowego.
Introduction. Thyroid diseases affect about 20% of Poles, the disease is more common in women than in men. About 20,000 procedures of this type are performed in Poland every year. Surgery is a very difficult situation for every patient. Related to this is feeling anxious and anxious. A nurse is a person who has direct and most frequent contact with a patient. It is able to detect any irregularities, which allows for a quick reaction and taking appropriate actions. Aim of the study. The aim of the study was to analyze the difference in calcium levels before and after thyroid surgery. Material and methods. The method of documentation analysis was used to conduct the research. The analyzed medical documentation concerned 100 patients after thyroidectomy . The results were statistically analyzed test x 2 for independent samples. The research material was divided into 5 areas: occurrence of a decrease in calcium after thyroid surgery, accompanying symptoms in the case of a decrease in calcium, occurrence of tetany symptoms after surgery, treatment with calcium preparations after surgery to remove the thyroid gland, and the influence of calcium levels on hospitalization time. Results. In the area of occurrence of a decrease in calcium after thyroid surgery, a significant decrease was observed. In the area of symptoms that occurred during the decrease in calcium, it was noticed that 86% of the operated patients did not experience any symptoms associated with the decrease in calcium. In the analysis of the area of tetany symptoms occurrence after surgery, no postoperative complications occurred among 72% of patients. In the area of treatment with calcium preparations, 25% of people required calcium supplementation after surgery, while 75% did not require calcium supplementation. In terms of the influence of calcium levels on hospitalization time, most of the patients, 74%, were hospitalized for less than 5 days after the surgery. Conclusions. 1. Lower calcium levels were observed after thyroidectomy. 2. The development of hypocalcaemia is characterized primarily by a tingling sensation around the mouth and hands, as well as muscle spasm and numbness in the limbs. 3. Despite the decrease in calcium, not all postoperative patients develop symptoms for this reason. 4. Supplementation with calcium preparations requires only some of the operated patients. 5. Along with the decrease in calcium levels, the hospitalization time after the thyroid gland removal procedure increases.
Źródło:
Innowacje w Pielęgniarstwie i Naukach o Zdrowiu; 2021, 6, 1; 37-49
2451-1846
Pojawia się w:
Innowacje w Pielęgniarstwie i Naukach o Zdrowiu
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
Tytuł:
Resection of liver metastases from differentiated thyroid cancer: who might benefit? A report of 2 cases with review of literature
Autorzy:
Ligocka, Joanna
Patkowski, Waldemar
Szparecki, Grzegorz
Ostrowski, Tomasz
Wiechno, Wiesław
Zieniewicz, Krzysztof
Powiązania:
https://bibliotekanauki.pl/articles/1392133.pdf
Data publikacji:
2019
Wydawca:
Index Copernicus International
Tematy:
iodine negative
liver surgery
thyroid neoplasms
Opis:
Background: Liver metastases of differentiated thyroid cancers (DTC) are uncommon. Surgery has proven to be effective in patients with 131I-negative hepatic lesions. Here, we present two patients who underwent liver resection for metastatic DTC. Case presentation: The first patient is a 36-year-old woman who reported with 70-mm hepatic metastases of papillary thyroid cancer. After primary treatment of cancer, she was disease-free for 8 years when the elevation of TSH levels resulted for the need to search for metastasis. Notably, the 131I SPECT did not show any lesions. The CT scan revealed an 80mm diameter mass in the liver. Histology confirmed metastasis of thyroid cancer. Lack of iodine uptake and the size of lesion excluded treatment with radioactive iodine. Radical resection of the metastasis was performed with good short- and long-term postoperative result. The second patient is a 65-year-old man previously treated for follicular thyroid cancer. When a iodine-negative 70mm diameter metastasis was detected within the liver, he was referred for surgery. Extended right hepatectomy was performed. In a 12-months follow-up, he remained stable, with no signs of recurrence. Conclusions: These two cases show that resection of hepatic metastases of DTC is an option even in the case of large lesions. Given the effectiveness and safety of liver surgery, we reckon that it should be the treatment of choice when possible. The decision to perform surgical treatment should be based on analysis of the ability to perform radical and safe resection.
Źródło:
Polish Journal of Surgery; 2019, 91, 4; 52-56
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
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