A History of Thyroid Surgery

Hegner, Casper F.

doi:10.1097/00000658-193204000-00001

Cited by 43 publications

(38 citation statements)

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“…This high mortality possibly reflected a lack of knowledge concerning the parathyroid glands and their influence on calcium metabolism (1). By 1912, Theodore Kocher recognized the need to preserve parathyroid glands, and had successfully performed more than 5000, mostly subtotal thyroidectomies (1)(2)(3).…”

Section: Introductionmentioning

confidence: 99%

Parathyroid hormone: an early predictor of symptomatic hypocalcemia after total thyroidectomy

Vanderlei

Vieira

Hojaij

et al. 2012

Arq Bras Endocrinol Metab

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Objective: The purpose of this study was to evaluate if the measurement of peri-operative parathyroid hormone (PTH) is able to identify patients with increased risk of developing symptoms of hypocalcemia. Subjects and methods: Forty patients who underwent total thyroidectomy were studied prospectively. Ionized serum calcium and PTH were measured after induction of anesthesia, one hour (PTH1) and one day after surgery (PTH24). Patients were evaluated for symptoms of hypocalcemia and treated with calcium and vitamin D supplementation as necessary. Results: Symptomatic hypocalcemia developed in 16 patients. Symptomatic patients had significant lower PTH1 and greater drops in PTH levels. The selection of 12.1 ng/L as PTH1 level cutoff level divided patients with and without symptoms with 93.7% sensitivity and 91.6% specificity. The selection of 73.5% as the cutoff value for PTH decrease resulted in 91.6% sensitivity and 87.5% specificity. Conclusion: PTH1 levels and the drop in PTH levels are reliable predictors of developing symptomatic hypocalcemia after total thyroidectomy. Arq Bras Endocrinol Metab. 2012;56(3):168-72 Keywords Thyroid gland; PTH; hypocalcemia; thyroidectomy; parathyroid gland RESUMO Objetivo: O objetivo deste estudo é avaliar se a medida perioperatória do hormônio da paratireoide (PTH) pode identificar os pacientes com maior risco de desenvolver sintomas de hipocalcemia. Sujeitos e métodos: Foram estudados quarenta pacientes submetidos à tireo diectomia total. A medida do cálcio sérico e do PTH foi feita após a indução anestésica, uma hora (PTH1) e um dia após a cirurgia. Os pacientes foram avaliados quanto à presença de sintomas de hipocalcemia e tratados com suplementação de cálcio e vitamina D quando necessário. Resultados: Dezesseis pacientes apresentaram sintomas de hipocalcemia. Os pacientes sintomáticos apresentaram PTH1 significantemente menor e queda no PTH significativamente maior. Usando o valor de 12,1 ng/L como corte, conseguimos distinguir pacientes com e sem sintomas de hipocalcemia com sensibilidade de 93,7% e especificidade de 91,6%. Utilizando como corte a queda de 73,5% no valor do PTH, temos sensibilidade de 91,6% e especificidade de 87,5%. Conclusão: O PTH1 e a queda no PTH são bons preditores de hipocalcemia no pós-operatório de tireoidectomia total Arq Bras Endocrinol Metab. 2012;56(3):168-72

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Section: Introductionmentioning

confidence: 99%

Parathyroid hormone: an early predictor of symptomatic hypocalcemia after total thyroidectomy

Vanderlei

Vieira

Hojaij

et al. 2012

Arq Bras Endocrinol Metab

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“…[1] The first credible account of thyroid surgery was given in 1170 by Roger Frugardi Salerno in the Bamberg manuscripts [2] . The mortality of thyroid surgery in early 1800s was approximately 50%.…”

Section: Introductionmentioning

confidence: 99%

Study of Complications of Thyroidectomy with Special Reference to Recurrent Laryngeal Nerve Injury

Sreejayan¹,

Arun²,

Ravindran³

et al. 2017

AIMDR

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Background: Thyroidectomy is one of the most commonly performed procedure for thyroid disorders. The mortality and mobidity of thyroidectomy was very high. Sterile surgical arenas, advent of anaesthesia, and improved surgical techniques have reduced it considerably. Patients must be appropriately counseled in the preoperative period regarding the potential complications. They must be well aware of the surgical risks they are to undertake. A thorough understanding of anatomy and with experience, the surgeon can minimise the risk associated with the procedure. Aim: Study the incidence of complications of thyroidectomy with special reference to recurrent laryngeal nerve injury. Methods: This is a hospital based prospective study, from 2008 to 2015.823 cases who underwent thyroidectomy for any indications at a tertiary care institution at north Malabar .Data collection: A detailed clinical evaluation was done. Intra operative documentation of surgical details was done. Post operatively the patients were monitored for any complications. Follow up serum TSH was monitored in second post op week, and then every month till six months. Results: The overall incidence of complications is 35.76%. Commonest complication is transient hypoparathyroidism(21.87%), followed by transient RLN injury (3.4%), permanent hyoparathyroidism (3.2%), flap edema (2.3%), EBSLN injury (2.06%), hematoma (1.45%), hypothyroidism (0.97%) and wound infection (0.73%). Conclusion: Meticulous dissection, absolute hemostasis, and a thorough knowledge of neck anatomy are the key in reducing the post thyroidectomy complications. Identification and preservation of the laryngeal nerves and parathyroids are mandatory. Incidences of other complications are on the decline.

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“…Prior to the development of adequate hemostatic and antiseptic techniques, open thyroidectomy carried an extremely high risk of morbidity and death. 1 However, contributions from surgeons, such as Billroth, Kocher, Halsted and Mayo rapidly transformed thyroidectomy into a safe operation. 1 In fact, the standard technique of open thyroidectomy changed only modestly from the standard open approach that was established by these surgical pioneers over the next century.…”

Section: Introductionmentioning

confidence: 99%

“…1 However, contributions from surgeons, such as Billroth, Kocher, Halsted and Mayo rapidly transformed thyroidectomy into a safe operation. 1 In fact, the standard technique of open thyroidectomy changed only modestly from the standard open approach that was established by these surgical pioneers over the next century. The introduction of video-assisted and endoscopic cervical approaches to thyroidectomy in the new millennium has changed the operative technique employed by many surgeons in order to minimize cervical scars.…”

Section: Introductionmentioning

confidence: 99%

Operative Technique for Single Incision Robot-Assisted Transaxillary Thyroid Surgery

Landry¹,

Kwon²,

Grubbs³

et al. 2011

World Journal of Endocrine Surgery

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During the past five years, transaxillary approaches to thyroid surgery have been introduced into surgical literature. These techniques were initially performed using traditional endoscopy, and most recently with a surgical robot. This manuscript describes our approach to robotassisted transaxillary surgery (RATS) for thyroidectomy using a single axillary incision. Because of the steep learning curve, this procedure is best implemented with a team approach. The ideal team consists of a console surgeon who operates the robot, a bedside surgeon who assists with retraction and troubleshoots robotic arm collisions and a circulating assistant who helps optimize the efficiency of the operation.

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A History of Thyroid Surgery

Cited by 43 publications

References 0 publications

Parathyroid hormone: an early predictor of symptomatic hypocalcemia after total thyroidectomy

Parathyroid hormone: an early predictor of symptomatic hypocalcemia after total thyroidectomy

Study of Complications of Thyroidectomy with Special Reference to Recurrent Laryngeal Nerve Injury

Operative Technique for Single Incision Robot-Assisted Transaxillary Thyroid Surgery

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