How to minimize complications in thyroid surgery?

Cernea, Cláudio Roberto; Brandão, Lenine Garcia; Hojaij, Flávio; Carlucci, Dorival de; Montenegro, Fábio Luiz de Menezes; Plopper, Caio; Vanderlei, Felipe Augusto Brasileiro; Gotoda, Renato; Dias, Fernando Luiz; Lima, Roberto A.

doi:10.1016/j.anl.2009.06.011

Cited by 42 publications

(36 citation statements)

References 17 publications

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“…In parallel with medical technologic developments and increased surgical experience, currently, surgery with low rates of mortality and morbidity has become a procedure of choice (1,2).…”

Section: Introductionmentioning

confidence: 99%

A complication of thyroidectomy: Do not forget suture reaction

et al. 2017

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Objective: In this study, we aimed to present patients who have developed suture reaction and were treated in our clinic following thyroidectomy operation. Material and Methods:Patients who had been treated for suture reaction following thyroidectomy between January 2012 and December 2014 were retrospectively evaluated. The patients were analyzed in terms of their age, gender, duration of the symptoms, type of previous operation and treatment modality. Results:Between January 2012 and December 2014, 559 thyroid/parathyroid operations were performed in our clinic. A total of 12 patients were admitted with suture reaction within this period thus yielding a suture reaction incidence of 2.1%. The mean age of these patients was 42±7.65 years, 75% of them were female while 25% of them were male. The types of previous operations were bilateral total thyroidectomy in 83.3%, lobectomy in 8.3% and near total thyroidectomy in 8.3% of the patients. The mean symptom duration was 7.2±4.3 (2-16) months. Two patients (16.7%) underwent a second surgical operation for suture reaction, while 10 patients (83.3%) were treated conservatively. None of the patients developed complications. Conclusion:One of the most common complications that develop after thyroidectomy is bleeding. Ligation must be performed in order to prevent this complication. As it is known, surgical ligation with sutures may cause tissue reaction. Sutures that are absorbable and have a low risk for reaction formation should be chosen if suturing is preferred.

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“…In parallel with medical technologic developments and increased surgical experience, currently, surgery with low rates of mortality and morbidity has become a procedure of choice (1,2).…”

Section: Introductionmentioning

confidence: 99%

A complication of thyroidectomy: Do not forget suture reaction

et al. 2017

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“…Nerve monitoring is recommended in revision surgery, thyroid cancer, patients with retrosternal extension or a giant goiter, and those who previously received radiotherapy. 22,23 Meticulous hemostasis and a delicate technique are required to prevent nerve and parathyroid gland injury. The knowledge of the anatomic variation of the parathyroid glands is of utmost value to the surgeon to avoid their inadvertent avulsion or devascularization.…”

mentioning

confidence: 99%

Effect of Recurrent Laryngeal Nerve Identification Technique in Thyroidectomy on Recurrent Laryngeal Nerve Paralysis and Hypoparathyroidism

Veyseller

Aksoy²,

Yıldırım³

et al. 2011

Arch Otolaryngol Head Neck Surg

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Comparing the 2 groups based on the frequencies of RLN paralysis and hypoparathyroidism, we found that complications were significantly lower in the first group (P < .05) in terms of hypoparathyroidism. The rate of hypoparathyroidism was significantly lower in the thyroidectomies that located the RLN using the superior-inferior approach. In our hands, the superior-inferior approach was a safer technique, in terms of avoiding complications.

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“…First thyroid surgery was performed by Theodor Kocher in 1889 a Swiss surgeon. 11 The complications remain the same even though the adjuvant methods of identifying the RLN, advanced anesthetic equipment are used in the modern times.…”

Section: Discussionmentioning

confidence: 99%

“…10 Similarly patients presenting with hard nodules in the thyroid gland, suspected carotid compression and bruit heard on auscultation of the thyroid gland are subjected to X-ray neck lateral view, CT scan with contrast or MRI to diagnose tracheal compression and high vascularity of the tumor. 11,12 These would help in accurate diagnosis as well as total excision of the tumor. 13,14 Most of the surgeries of thyroid were not associated with Hypocalcaemia during the post-operative period in the present study similar to the age group factor, type of Histopathology of the tumor (Table6).…”

Section: Discussionmentioning

confidence: 99%

Role of Pre - Operative Investigations in Preventing the Post - Operative Complications of Thyroid Surgery

Reddy¹,

Ram²

2015

jemds

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Thyroid surgeries are performed worldwide for various indications. In the past complications of thyroid surgeries were reported more than 24%. With an increase in accuracy in Cytological reporting, non-invasive radiological investigations to know the extent of the tumor and infiltration of malignant tumors, the complications are reduced to less than 4%. AIM: To evaluate the predictability of pre-operative investigations in preventing the post-operative complications of thyroid surgery. MATERIALS AND METHODS:A prospective study conducted on 86 patients by investigating before thyroid surgeries with FNAC, ultrasonography, CT scan, X-ray Neck lateral view, MRI, 2D ECHO of Cardia, isotope scanning, video laryngoscopy and thyroid function tests. Demographic characteristics of the patients and indications for thyroid surgeries were used to predict the postoperative complications. Post-operative investigations included serum calcium levels, Thyroid function tests and serum Electrolyte levels to diagnose the complications. RESULTS: sensitivity of FNAC was 93.33%, ultra sound Neck was 92.83%, serum calcium was 89.16%, in thyroid function tests it was 77.66%. With X-Ray Neck the specificity was 57.66%, CT scan was 44.50%, MRI was 15%, and isotope study was 30.6%, Doppler study was 33.83% and 2DEcho was 27.83%. Pre-operative assessment was Airway obstruction 3.48%, hematoma formation 4.65%, RLN palsy 3.48%, Hypocalcaemia 33.72%, wound infection 4.65% were the complications encountered. CONCLUSIONS: Thorough investigations prior to surgery of thyroid, proper selection of the surgical procedure, tumor location knowledge, understanding the pathophysiology of the thyroid disease and type of anesthesia gives confidence to the surgeon and avoids complications. The methods applied in the present study had a definitive role in preventing hypocalcaemia with an incidence of 33.72% and RLN palsy 3.48%. These were added upon by the experience of the operating surgeon.

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How to minimize complications in thyroid surgery?

Cited by 42 publications

References 17 publications

A complication of thyroidectomy: Do not forget suture reaction

A complication of thyroidectomy: Do not forget suture reaction

Effect of Recurrent Laryngeal Nerve Identification Technique in Thyroidectomy on Recurrent Laryngeal Nerve Paralysis and Hypoparathyroidism

Role of Pre - Operative Investigations in Preventing the Post - Operative Complications of Thyroid Surgery

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