Can we consider immediate complications after thyroidectomy as a quality metric of operation?

Lifante, Jean-Christophe; Payet, Cécile; Ménégaux, Fabrice; Sébag, F.; Kraimps, Jean‐Louis; Peix, Jean‐Louis; Pattou, François; Colin, Cyrille; Duclos, Antoine; Arnalsteen, Laurent; Caizzo, Robert; Carnaille, B.; Dezfoulian, Guélareh; Eberle, Carole; Khatib, Ziad El; Fernandez, E. Rodriguez; Lamblin, Antoine; Six, Marie-France; Bourdy, Stéphanie; Bouveret, Laetitia; Guibert, Benoît; Pogam, Marie-Annick Le; Singier, Gaétan; Soardo, Pietro; Touzet, Sandrine; Voirin, Nicolas; Auquier, Pascal; Henry, Jean-François; Morando, Claire; Slycke, Sam Van; Akrout, I.; Benmiloud, Fares; Chigot, Jean-Paul; Colombet, Isabelle; Godiris-Petit, G.; Leyre, P.; Noullet, S.; Royer, B.; Trésallet, Christophe; Desurmont, Thibault; Dominguez, Claudia; Odasso, Chiara; Rouleau, Laëtitia; Chapuis, Y; Durieux, Pierre; Lepape, Alain; Triponez, Frédéric

doi:10.1016/j.surg.2016.04.049

Cited by 34 publications

(24 citation statements)

References 19 publications

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“…Approximately half of the patients with postoperative RLN palsy refused the 6‐month laryngoscopy, resulting in a possible underestimation of the rate of definitive RLN palsy. However, it has been shown that the rate of definitive palsies is correlated to the rate of immediate postoperative palsies …”

Section: Discussionmentioning

confidence: 99%

Impact of body mass index on post‐thyroidectomy morbidity

et al. 2019

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Background The impact of obesity on total thyroidectomy (TT) morbidity (recurrent laryngeal nerve palsy and hypocalcaemia) remains largely unknown. Methods In a prospective study (NCT01551914), patients were divided into five groups according to their body mass index (BMI): underweight, normal weight, overweight, obese, and severely obese. Preoperative and postoperative serum calcium was measured. Recurrent laryngeal nerve (RLN) function was evaluated before discharge, and if abnormal, at 6 months. Results In total 1310 patients were included. Baseline characteristics were similar across BMI groups except for age and sex. Postoperative hypocalcaemia was more frequent in underweight compared to obese patients but the difference was not statistically significant in multivariate analysis. There was no difference between groups in terms of definitive hypocalcaemia, transient and definitive RLN palsy, and postoperative pain. Conclusion Obesity does not increase intraoperative and postoperative morbidity of TT, despite a longer duration of the procedure.

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Section: Discussionmentioning

confidence: 99%

Impact of body mass index on post‐thyroidectomy morbidity

et al. 2019

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“…In long term, about a quarter of patients with protracted hypoPT will develop permanent hypoPT. A prospective, cross-sectional study of 3605 patients operated in five academic hospitals by 22 participating surgeons found no correlation between immediate and permanent hypoPT [ 10 ] as most patients have only transient hypoPT. Slow recovery of hypoPT has been reported to occur in up to 2 years after surgery [ 11 ] hence regular biochemical assessment is necessary in such patients.…”

Section: Introductionmentioning

confidence: 99%

Patients’ views about parathyroid transplantation for post-thyroidectomy hypoparathyroidism

Schmeißer

Mihai

2018

Langenbecks Arch Surg

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BackgroundPermanent hypoparathyroidism (hypoPT) represents the most common postoperative complication associated with total thyroidectomy. Current treatment relies on high-dose calcium and/or vitamin D supplementation, but often this is insufficient and some patients remain symptomatic. Parathyroid allotransplantation is a new therapeutic option described recently in the literature. This study aims to investigate the patients’ acceptability of parathyroid transplantation as a potential new treatment for hypoPT.MethodOnline survey of members of HypoParaUK, a support group for individuals affected by hypoPT.ResultsResponses were received from 252 hypoPT patients. Majority declared to experience severe symptoms despite regular medical treatment. On a severity scale of 0–5, symptoms that were most troublesome were fatigue (3.8), low sense of well-being (3.5), and numbness/tingling (2.9). On a scale of 0–10, on average, their current quality of life (QoL) was 5 ± 3 and they expected this would improve to 7 ± 2 with correction of their hypoPT. Forty-four percent of patients were extremely interested in a potential technique involving intramuscular injection of parathyroid cell suspension compared to just 14% who were interested in the more invasive procedure of implantation of a parathyroid allograft into the forearm. The main concerns expressed were related to the possible need for immunosuppressive therapy.ConclusionPatients with severe symptomatic hypoPT seem interested to consider participation in a clinical trial exploring the feasibility and success rate of parathyroid transplantation.Electronic supplementary materialThe online version of this article (10.1007/s00423-018-1693-y) contains supplementary material, which is available to authorized users.

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“…Among 4 studies examining permanent rates of VCP and hypoparathyroidism, 2 also identified permanent complications as occurring at 6 months after surgery, although the study follow-up period was also 6 months. 24,25 The reported rates of permanent VCP were 2.1% and 3.1%, 24,25 to which our rate of 1.8% for permanent VCP 6 to 18 months after surgery compares favorably. The other 2 studies identified permanent VCP as occurring after 1 year and reported rates of 1.0% to 1.1%.…”

Section: Discussionmentioning

confidence: 64%

Association Between Annual Surgeon Total Thyroidectomy Volume and Transient and Permanent Complications

Meltzer

Hull

Sundang³

et al. 2019

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Although the association between annual surgeon total thyroidectomy volume and clinical outcomes is well established, published methods typically group surgeons into volume categories. The volume-outcomes association is likely continuous, but little is known about the point at which the annual surgeon procedure volumes begin to be associated with a decrease in complication rates. OBJECTIVE To model the volume-outcomes association as a continuous function and identify the point at which increasing surgeon volume begins yielding better outcomes.

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Can we consider immediate complications after thyroidectomy as a quality metric of operation?

Cited by 34 publications

References 19 publications

Impact of body mass index on post‐thyroidectomy morbidity

Impact of body mass index on post‐thyroidectomy morbidity

Patients’ views about parathyroid transplantation for post-thyroidectomy hypoparathyroidism

Association Between Annual Surgeon Total Thyroidectomy Volume and Transient and Permanent Complications

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