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Microsurgery 2021 May 14. Epub 2021 May 14.

Division of Plastic and Reconstructive Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China.

Background: Treatment decisions can be challenging in patients undergoing multiple oropharyngeal microsurgical reconstructions at different periods by various causes. We, retrospectively, reviewed patients with at least three consecutive free flap reconstructions to determine the optimal strategy for selecting recipient vessels.

Methods: Then, 36 patients (33 men and 3 women) who underwent at least 3 microsurgical reconstructions with a total of 51 free flap transfers for head and neck defects were included in this report. Read More

BMJ Case Rep 2021 May 13;14(5). Epub 2021 May 13.

Medicine Based Disciplines Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia

Recurrent laryngeal nerve (RLN) injury is one of the main complications of total thyroidectomy. If the injury is bilateral, total airway obstruction, aphonia and hoarseness of voice could be precipitated. Hence, it is wise for the operating surgeon to be guided by neural monitoring during thyroidectomy. Read More

Front Oncol 2021 26;11:665240. Epub 2021 Apr 26.

Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China.

Background: Sentinel lymph node (SLN) biopsy is feasible for breast cancer (BC) patients with clinically negative axillary lymph nodes; however, complications develop in some patients after surgery, although SLN metastasis is rarely found. Previous predictive models contained parameters that relied on postoperative data, thus limiting their application in the preoperative setting. Therefore, it is necessary to find a new model for preoperative risk prediction for SLN metastasis to help clinicians facilitate individualized clinical decisions. Read More

Acta Med Port 2021 Mar 1;34(3):229-231. Epub 2021 Mar 1.

Department of Otolaryngology, Head and Neck Surgery. University of Medical Sciences. Poznań. Institute of Human Genetics. Polish Academy of Sciences. Poznań. Poland.

The aim of this case report is to present an incidental finding of a firm tracheal septum in a 61-year-old woman. The patient was admitted to the hospital with mild dyspnea and a preliminary diagnosis of a tracheal subglottic stenosis. During microlaryngoscopy, just below the subglottic stenosis, a firm, vertical symphysis (septum), forming a double-lumen trachea was found. Read More

Langenbecks Arch Surg 2021 May 10. Epub 2021 May 10.

Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea.

Purpose: Thyroid lobectomy is now preferred over total thyroidectomy to preserve thyroid function and reduce complications in patients with low-risk papillary thyroid carcinoma (PTC). One inevitable consequence of thyroidectomy includes hypothyroidism. This study aimed to evaluate the risk factors for hypothyroidism and thyroid hormone replacement after hemithyroidectomy in patients with PTC. Read More

Gland Surg 2021 Apr;10(4):1359-1367

General Surgery Unit, Department of Medicine and Surgery, Parma University Hospital, Parma, Italy.

Background: Thyroid cancer is the ninth most commonly diagnosed cancer in the world, and the most common endocrine carcinoma. It was originally believed to be a rare event in patients with thyroid hyperfunction and it was reported that hyperthyroidism had a protective role against thyroid neoplasms. However, in recent years, several studies have hypothesized that differentiated thyroid carcinomas and hyperthyroidism may coexist. Read More

Georgian Med News 2021 Mar(312):14-22

1I.M. Sechenov First Moscow State Medical University (Sechenov University), Department of Faculty Surgery N2, Russian Federation.

The level of calcium in the blood serum, voice function, thyroid status and quality of life of patients up to 1 year after removal of the thyroid gland were studied. Thyroidectomy is an operation associated with a high risk of postoperative hypocalcemia with clinical manifestations (19.6%), which is transient in 15. Read More

Clin Endocrinol (Oxf) 2021 May 4. Epub 2021 May 4.

Department of Endocrinology and Diabetes, the First Affiliated Hospital of Xiamen University, Xiamen, China.

Objective: For 1-4cm differentiated thyroid cancer (DTC), current ATA guideline recommended hemithyroidectomy (HT) as an acceptable alternative initial procedure to total or near total thyroidectomy (TT). The aim of this study was to evaluate benefits and harms of HT, TT in 1-4cm DTC.

Methods: In this retrospective cohort study, DTC patients who underwent initial thyroidectomy in a tertiary medical center were included. Read More

Cureus 2021 Mar 31;13(3):e14219. Epub 2021 Mar 31.

Department of Pulmonary and Critical Care Medicine, Detroit Medical Center Sinai-Grace Hospital, Detroit, USA.

Thyroid storm is an extremely rare yet life-threatening medical emergency. It results from the decompensation of undiagnosed or undertreated hyperthyroidism in the presence of an acute stressor such as trauma to the thyroid, infections, acute iodine load, withdrawal from the antithyroid medication, or surgical procedures (including thyroid surgery). Clinical features of thyroid storm include hyperthermia, tachycardia, respiratory distress, gastrointestinal and hepatic symptoms, and central nervous system dysfunction. Read More

BMC Infect Dis 2021 May 4;21(1):412. Epub 2021 May 4.

Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

Background: Since the outbreak of coronavirus disease 2019 in December 2019, more than 8 million cases have occurred worldwide as of June 16, 2020. However, it is important to distinguish COVID-19 from other respiratory infectious diseases, such as influenza. Here, we comparatively described the clinical characteristics of children with COVID-19 and paediatric patients with influenza. Read More

J Surg Res 2021 Apr 30;265:147-152. Epub 2021 Apr 30.

Department of General Surgery, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey.

Background: Revision of any neck surgeries is usually associated with increased rate of complications compared to the initial surgery due to adhesions. Especially, recurrent laryngeal nerve injury and hypoparathyroidism are most important postoperative complications of thyroid revision surgery. This study aimed to reveal anti-adhesive effects of cross-linked hyaluronic acid gel (NCHAG) in thyroid surgery. Read More

Arch Endocrinol Metab 2021 Apr 29. Epub 2021 Apr 29.

Faculdade de Medicina da Bahia (UFBA), Salvador, BA, Brasil.

Objective: Percutaneous ethanol injection (PEI) is an alternative to surgery for the treatment of thyroid nodules (TNs). However, size reductions of treated (TTNs) and untreated TN (UTNs) have not been compared. Volumetric reductions in TTNs with PEI were evaluated by comparing TTNs and UTNs in the same patient, and independent variables predicting good post-PEI outcomes were analyzed. Read More

Value Health 2021 05 5;24(5):648-657. Epub 2021 Mar 5.

Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.

Objectives: Coronavirus disease 2019 has put unprecedented pressure on healthcare systems worldwide, leading to a reduction of the available healthcare capacity. Our objective was to develop a decision model to estimate the impact of postponing semielective surgical procedures on health, to support prioritization of care from a utilitarian perspective.

Methods: A cohort state-transition model was developed and applied to 43 semielective nonpediatric surgical procedures commonly performed in academic hospitals. Read More

Endocrinol Diabetes Metab Case Rep 2021 Apr 1;2021. Epub 2021 Apr 1.

Endocrine CentreToranomon HospitalMinato-ku, Tokyo, Japan.

Summary: A 50-year-old woman with thyroid-stimulating hormone (TSH)-producing pituitary adenoma (TSHoma) was diagnosed due to symptoms of thyrotoxicosis. Preoperatively, she showed thyrotoxicosis with the syndrome of inappropriate secretion of TSH (SITSH) and had a 5 cm nodule in her thyroid gland. Octreotide was administered preoperatively, which helped lower her serum TSH level but not her thyroid hormone level. Read More

J Pediatr Surg 2021 Mar 26. Epub 2021 Mar 26.

Division of Pediatric Surgery, Department of Surgery, Children's Medical Center, University of Texas Southwestern, Dallas TX USA. Electronic address:

Background: Thyroglossal Duct Cyst (TDC) is the most common congenital neck mass in children and is surgically managed with a Sistrunk procedure. Some surgeons perform a modified Sistrunk (mSis), involving the dissection of the fistula beyond the hyoid bone without coring out the foramen cecum at the base of the tongue. We aim to evaluate surgical outcomes of children undergoing Sistrunk (Sis) or modified Sistrunk (mSis) procedures for TDC at an academic pediatric institution. Read More

J Clin Med 2021 Apr 15;10(8). Epub 2021 Apr 15.

Department of Surgery, Seoul National University College of Medicine, Seoul 03080, Korea.

Background: Bilateral axillo-breast approach (BABA) robotic thyroidectomy has been successfully performed for thyroid cancer patients with excellent cosmetic results. Completion thyroidectomy is sometimes necessary after thyroid lobectomy, and whether it has a higher complication rate than the primary operation due to the presence of adhesions remains controversial. The aim of this study was to evaluate surgical outcomes, including operation time and postoperative complications, in patients who underwent BABA robotic completion thyroidectomy. Read More

Surg Oncol 2021 Apr 6;38:101550. Epub 2021 Apr 6.

St.Paul's Hospital & University of British Columbia, Department of Surgery, Vancouver, British Columbia, Canada. Electronic address:

Background: The study aim was to systematically review literature evaluating surgeon volume-outcome relationships for thyroid and parathyroid operations in order to inform surgical quality improvement initiatives. Current literature suggests surgeons who perform a high volume of thyroid and/or parathyroid operations have better outcomes than low volume surgeons, though specific volume definition are not standardized.

Methods: Eligible studies were selected through a literature search focused on the effect of surgeon volume on thyroid and parathyroid surgery patient outcomes. Read More

Updates Surg 2021 Apr 29. Epub 2021 Apr 29.

Department of Head and Neck Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Zhejiang, 310014, China.

This study aimed to compare the surgical safety and outcomes of the transoral endoscopic thyroidectomy vestibular approach (TOETVA) and gasless endoscopic thyroidectomy transaxillary approach (GETTA). This retrospective study assessed 150 patients managed with the TOETVA at the Yantai Yuhuangding hospital and 150 patients managed via the GETTA at the Zhenjiang Provincial People's Hospital. The procedures were compared in terms of workspace creation time, operating time, complications, post-operative complaints, cosmetic satisfaction, and the efficacy of central neck lymph-node dissection. Read More

Rozhl Chir 2021 ;100(3):118-125

Introduction: The incidence of thyroid disorders has been rising worldwide. Unlike the incidence, mortality associated with malignant thyroid cancer shows only a modest increase. Between 1979 and 2009, mortality in Czech women increased from 1. Read More

BMC Surg 2021 Apr 27;21(1):220. Epub 2021 Apr 27.

Department of Radiology, Chungbuk National University Hospital, 776, 1sunhwan-ro, Seowon-g, Cheongju-si, Chungcheongbuk-do, Republic of Korea.

Background: Fine needle aspiration (FNA) of the thyroid gland is an effective and safe method for evaluating thyroid nodules; catastrophic complications following FNA of thyroid are rare. Massive hematomas with active bleeding leading to airway compromise are extremely rare complications of FNA, with only a few reported cases in literature.

Case Presentation: An 80 year-old man presented to the emergency room with severe respiratory distress, four hours after undergoing thyroid FNA for the evaluation of a thyroid nodule. Read More

Radiology 2021 Apr 27:202735. Epub 2021 Apr 27.

From the Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing 100029, China (X.J.C., Y.W., Z.L.Z., L.L.P., Y.L., M.A.Y.); Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China (S.R.W., L.Q.); Department of Ultrasound, the First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C., Y.L.Z.); Department of Thyroid, Beijing Beicheng Chinese Medicine Hospital, Beijing, China (J.L.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Ultrasound, the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou, China (J.F.H., G.Z.Y.); Department of Breast and Thyroid Surgery, People's Hospital of Xinjiang Uygur Autonomous, Wulumuqi, China (H.L.W., A.S.); Department of Ultrasound, Wuhai People's Hospital, Wuhai, China (G.L.); Department of Interventional Ultrasound, Qinghai Provincial People's Hospital, Xining, China (J.Q.G.); Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H., X.F.L.); Special Inspection Section, Wendeng District People's Hospital, Wendeng, China (Z.H.W.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Y.Z.); Department of Ultrasound, Bayannur Hospital, Bayannur China (M.J.); and Department of Ultrasound, Laixi Municipal Hospital, Laixi, China (L.L.S.).

Background Microwave ablation (MWA) and radiofrequency ablation (RFA) have recently attracted interest as minimally invasive treatment modalities for papillary thyroid carcinoma (PTC). However, the ablation outcomes of T1N0M0 PTC are not well characterized. Purpose To evaluate the efficacy and safety of thermal ablation (MWA or RFA) of solitary T1N0M0 PTC in patients who were ineligible for (due to presence of comorbid cardiovascular disease, renal failure, other malignancy, etc) or who refused surgery. Read More

Surg Laparosc Endosc Percutan Tech 2021 Apr 23. Epub 2021 Apr 23.

First People's Hospital of Zunyi/Third Affiliated Hospital of Zunyi Medical University Department of Thyroid Surgery, First People's Hospital of Zunyi/Third Affiliated Hospital of Zunyi Medical University, Zunyi, China.

Objective: To determine the feasibility of endoscopic thyroidectomy with level Vb dissection using a chest-breast approach.

Methods: Lateral neck level Vb dissection by endoscopic surgery using a chest-breast approach was performed as an update to the previously reported endoscopic selective lateral neck dissection. The demographic data, surgical outcomes, and adverse events were analyzed. Read More

Cureus 2021 Mar 22;13(3):e14045. Epub 2021 Mar 22.

Internal Medicine, Unity Health, Searcy, USA.

Thyroid storm is an acute, life-threatening syndrome due to an exacerbation of thyrotoxicosis, which is when you have an excess of thyroid hormone in the body. Thyroid storm can be precipitated by infections, surgery, or untreated thyrotoxicosis. Multisystem involvement is often seen. Read More

Front Endocrinol (Lausanne) 2021 7;12:638608. Epub 2021 Apr 7.

Department of Otolaryngology-Head and Neck Surgery, E-Da Hospital, Kaohsiung, Taiwan.

Over the past decade, the use of neuromonitoring in thyroid surgery has become well established and is increasing accepted across the world. In addition, new developments in energy devices have significantly improved efficacy in achieving hemostasis in thyroid surgery. Few studies focused on the complication rates in energy device-assisted sutureless neuro-monitored thyroidectomy. Read More

Surg Today 2021 Apr 23. Epub 2021 Apr 23.

Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima, 890-8520, Japan.

Purpose: To investigate the drainage patterns of the inferior mesenteric vein (IMV) and measure the distance from the root of the inferior mesenteric artery (IMA) to the IMV using preoperative three-dimensional computed tomography (3D-CT) angiography in patients undergoing surgery for left-sided colorectal cancer.

Methods: In this retrospective study, we analyzed data collected prospectively on 167 consecutive patients who underwent laparoscopic left-sided colorectal cancer surgery between July, 2014 and August, 2019. The drainage pattern of the IMV and the distance from the root of the IMA to the IMV were evaluated using 3D-CT angiography. Read More

Minerva Surg 2021 Apr 23. Epub 2021 Apr 23.

Unit of General Surgery, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy.

Background: The diagnosis of thyroid carcinoma has changed in last decades, as the surgical technique during thyroidectomy (endoscopic surgery, robotic surgery, new energy device, intraoperative neuromonitoring).

Methods: We analyzed patients undergone to thyroidectomy or lobectomy for thyroid carcinoma from January 2010 to December 2019 at the General Surgery Unit of the Hospital - University of Parma. We divided patients into two groups, based on the use or not of IONM. Read More

BMC Womens Health 2021 Apr 21;21(1):169. Epub 2021 Apr 21.

Department of Thyroid and Breast Surgery, The First Affiliated Hospital of Chengdu Medical College, 278 Baoguang Avenue Middle Section, Xindu District, Chengdu City, 610500, Sichuan Province, China.

Background: Trastuzumab is currently the standard treatment for human epidermal growth factor receptor 2 (HER2)-positive breast cancer. However, it is not recommended for HER2-positive breast cancer patients during pregnancy as it may jeopardize safety of the fetus. Nevertheless, there is evidence that fetuses exposed to trastuzumab in early stages of pregnancy remain healthy METHODS: To evaluate the possible effects of trastuzumab on fetus and provide evidence on the safety of trastuzumab in early pregnancy in HER2-positive breast cancer patients, we analyzed 22 studies involving 22 pregnant women and 23 fetuses. Read More

Eur Radiol 2021 Apr 21. Epub 2021 Apr 21.

Department of Ultrasound, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 2nd Ruijin Road 197, Shanghai, 200025, People's Republic of China.

Objectives: Up to 40% of papillary thyroid cancer (PTC) patients have lymph node metastasis, a condition that implies persistent, recurrent, or progressive disease. However, the American Joint Committee on Cancer Manual states that there is no reliable examination for adequate lymph node staging. Therefore, our aim is to develop a lymphatic imaging technique using ultrasonography to address this challenge. Read More

Curr Med Sci 2021 Apr 20;41(2):348-355. Epub 2021 Apr 20.

Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

Hyperthyroid heart disease (HHD) is one of the most severe complications of overt hyperthyroidism and increases the risk of mortality in affected patients. Early identification of patients at a higher risk of developing HHD can improve clinical outcomes through active surveillance and management. Connective tissue growth factor (CTGF), a secreted extracellular protein, plays a significant role in cardiac remodeling and dysfunction. Read More

BMJ Case Rep 2021 Apr 19;14(4). Epub 2021 Apr 19.

Division of Endocrinology, Diabetes, and Metabolism, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.

A 74-year-old woman with a history of primary hyperparathyroidism, thyroid nodules, atrial fibrillation and pacemaker placement for sick sinus syndrome presented with fatigue, constipation and persistent lower extremity oedema. She underwent subtotal parathyroidectomy and left thyroid lobectomy. Histopathology revealed amyloidosis affecting the thyroidand parathyroids confirmed by Congo Red Staining with Mayo Clinic subtyping of light chain kappa-type amyloidosis. Read More