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    Efficacy and safety of LigaSure™ small jaw instrument in thyroidectomy: a 1-year prospective observational study.
    Eur Arch Otorhinolaryngol 2018 Mar 13. Epub 2018 Mar 13.
    Department of Head and Neck Surgery, Zhejiang Cancer Hospital, Hangzhou, 310022, China.
    Purpose: To compare the efficacy and safety profiles of LigaSure™ small jaw instrument (LSJI) versus conventional technique in patients undergoing open thyroidectomy.

    Methods: This single-center, prospective, observational study conducted in Zhejiang Provincial Cancer Hospital enrolled patients who underwent thyroidectomy between September 2013 and September 2014. The primary study outcomes included determination of blood loss, operative duration, length of hospital stay, and drainage volume. Read More

    Health-Related Quality of Life in patients with Non-Surgical Hypoparathyroidism and Pseudohypoparathyroidism.
    Clin Endocrinol (Oxf) 2018 Mar 9. Epub 2018 Mar 9.
    Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Tage-Hansens Gade, Denmark.
    Objective: Non-surgical hypoparathyroidism (NS-HypoPT) and pseudohypoparathyroidism (PHP) are rare diseases, with a prevalence of 2/100.000 and 1/100.000, respectively. Read More

    Efficacy and safety of long-term management of patients with chronic post-surgical hypoparathyroidism.
    J Endocrinol Invest 2018 Mar 7. Epub 2018 Mar 7.
    Department of Clinical and Internal Medicine, University of Pisa, Via Paradisa 2, 56127, Pisa, Italy.
    Purpose: To evaluate adherence to European Society of Endocrinology guidelines and risk of renal complications in patients with chronic post-operative hypoparathyroidism (PO-HypoPT) treated with calcium and activated vitamin D metabolites.

    Methods: We evaluated 90 adult patients (68 females and 22 males) with chronic (3 years) PO-HypoPT. Total albumin-corrected (Alb-Ca) and ionized serum calcium, phosphate, creatinine, PTH, and 24-h urinary calcium were measured; renal ultrasound was also performed. Read More

    Prevalence of Chronic Hypoparathyroidism in a Mediterranean Region as Estimated by the Analysis of Anonymous Healthcare Database.
    Calcif Tissue Int 2018 Mar 8. Epub 2018 Mar 8.
    Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy.
    Epidemiological data on prevalence and incidence of chronic hypoparathyroidism are still scarce. This study aimed to establish prevalence of chronic hypoparathyroidism and incidence of surgical hypoparathyroidism using the analysis of electronic anonymous public health care database. Data referred to a 5-year period (2009-2013, Region of Tuscany, Italy, as a sample representative of the whole Mediterranean/European population, estimated mean population: 3,750,000 inhabitants) were retrieved by the analysis of pharmaceutical distribution dataset, containing data related to drugs reimbursed by public health system, hospital discharge and procedures codes, and ICD9 exemption codes for chronic diseases. Read More

    HypoparaNet: A Database of Chronic Hypoparathyroidism Based on Expert Medical-Surgical Centers in Italy.
    Calcif Tissue Int 2018 Mar 6. Epub 2018 Mar 6.
    Bone Metabolic Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
    Hypoparathyroidism is a rare disease characterized by low serum calcium levels and absent or deficient parathyroid hormone level. Regarding the epidemiology of chronic hypoparathyroidism, there are limited data in Italy and worldwide. Therefore, the purpose of this study was to build a unique database of patients with chronic hypoparathyroidism, derived from the databases of 16 referral centers for endocrinological diseases, affiliated with the Italian Society of Endocrinology, and four centers for endocrine surgery with expertise in hypoparathyroidism, to conduct an epidemiological analysis of chronic hypoparathyroidism in Italy. Read More

    Sanjad-Sakati syndrome with macrocytic anemia and failure to thrive: a case from South Jordan.
    J Pediatr Endocrinol Metab 2018 Mar 1. Epub 2018 Mar 1.
    Pediatric Department, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
    Backgorund: Sanjad-Sakati syndrome (SSS) is a rare autosomal recessive disease caused by a deletion mutation (155-166del) in exon 3 of the TBCE gene on chromosome 1q42-43. The syndrome is characterized by primary hypoparathyroidism, typical dysmorphic features and severe growth retardation.

    Case Presentation: We encountered a 2-year-old boy with hypocalcemia, failure to thrive and macrocytic anemia. Read More

    Recognition of sentinel lymph nodes in patients with papillary thyroid cancer by nano-carbon and methylene blue.
    Pak J Med Sci 2017 Nov-Dec;33(6):1485-1489
    Yuan Zhang, Department of Head and Neck Surgery, Jiangsu Cancer Hospital Affiliated to Nanjing Medical University, Nanjing 210009, P. R. China.
    Objective: To compare the accuracy and feasibility of methylene blue and nano-carbon in clinical tracing of sentinel lymph nodes (SLNs) in patients with papillary thyroid cancer (PTC).

    Methods: Ninety-six PTC patients were selected and randomly divided into a methylene blue group and a nano-carbon group (n=48). During surgery, tracer agent was injected around the tumor, and SLNs were resected and subjected to frozen pathological examination. Read More

    Misdiagnosis of idiopathic hypoparathyroidism: A case report and literature review.
    Medicine (Baltimore) 2018 Mar;97(9):e9884
    Department of Neurology, PLA 44 Hospital.
    Rationale: Idiopathic hypoparathyroidism (IHP) is a rare endocrine condition, which is frequently represented by neuropsychiatric disorders. Hence, the misdiagnosis rate of the disease is rather high, especially for neurologists.

    Patient Concerns: We reported a case of misdiagnosed, atypical IHP. Read More

    Acute Onset of Quadriplegia Secondary to Hypoparathyroidism: Mimicker of AMAN Variant of GBS.
    J Coll Physicians Surg Pak 2018 Mar;28(3):S23-S25
    Department Of Medicine, The Aga Khan University Hospital, Karachi.
    Acute onset of quadriplegia is a rare phenomenon seen with hypocalcemia due to hypoparathyroidism. We describe a 33-year gentleman who presented with weakness of all four limbs and areflexia. ECG showed QT abnormality. Read More

    Permanent Hypoparathyroidism After Total Thyroidectomy in Children: Results from a National Registry.
    World J Surg 2018 Feb 22. Epub 2018 Feb 22.
    Department of Clinical Science, Lund University, 221 85, Lund, Sweden.
    Introduction: Hypoparathyroidism is the most common complication following thyroidectomy. There are few population-based reports on the rate of hypoparathyroidism in children. The incidence of medical treatment of permanent hypoparathyroidism in children is reported using a national registry. Read More

    Bilateral patterns and motor function of the extralaryngeal branching of the recurrent laryngeal nerve.
    Surg Radiol Anat 2018 Feb 21. Epub 2018 Feb 21.
    Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Millet Caddesi Capa, Fatih, 34093, Istanbul, Turkey.
    Purpose: To evaluate the bilateral patterns and motor function of the extralaryngeal branches (ELB) of the recurrent laryngeal nerve(RLN).

    Methods: This study included 500 consecutive patients who underwent total thyroidectomy. Intraoperative nerve monitoring (IONM) was used in 230 patients. Read More

    Atypical microdeletion in 22q11 deletion syndrome reveals new candidate causative genes: A case report and literature review.
    Medicine (Baltimore) 2018 Feb;97(8):e9936
    Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University.
    Rationale: 22q11 deletion syndrome, the most common chromosomal microdeletion disease, is caused by megabase-sized deletions on chromosome 22q11.2. It is characterized by a wide spectrum of congenital anomalies in velopharyngeal and facial, cardiac, genitourinary, vertebroskeletal, respiratory, digestive, and central nervous systems. Read More

    Smith-Lemli-Opitz syndrome: clinical and biochemical correlates.
    J Pediatr Endocrinol Metab 2018 Feb 19. Epub 2018 Feb 19.
    Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, Australia.
    Background: Smith-Lemli-Opitz syndrome (SLOS) is an autosomal recessive disorder caused by mutations in the DHCR7 gene that result in reduced cholesterol biosynthesis. The aim of the study was to examine the biochemical and clinical features of SLOS in the context of the emerging evidence of the importance of cholesterol in morphogenesis and steroidogenesis.

    Methods: We retrospectively reviewed the records of 18 patients (including four fetuses) with confirmed SLOS and documented their clinical and biochemical features. Read More

    How many parathyroid glands can be identified during thyroidectomy?: Evidence-based data for medical experts.
    Eur Surg 2018 13;50(1):14-21. Epub 2017 Dec 13.
    1Second Department of Surgery "Kaiserin Elisabeth", Krankenanstalt Rudolfstiftung, Juchgasse 25, 1030 Vienna, Austria.
    Background: The purpose of this study is to provide guidance for medical experts regarding malpractice claims on permanent hypoparathyroidism by analyzing the number of parathyroid glands (PGs) identified during thyroidectomy and the clinical outcome.

    Methods: Parathyroid findings were documented in a standardized protocol for 357 patients undergoing thyroidectomy and treated by a single specialized surgeon. The resected thyroid was routinely dissected for accidentally removed PGs with consecutive autotransplantation and the pathological report also described unintentionally resected PGs. Read More

    MILK-ALKALI SYNDROME (MAS) as a complication of the treatment of hypoparathyroidism.
    Endokrynol Pol 2018 Feb 14. Epub 2018 Feb 14.
    Warsaw University of Medicine.
    Milk-alkali syndrome (MAS), characterized by renal failure, metabolic alkalosis and hypercalcemia, is a severe and life-threatening complication of the treatment of hypoparathyroidism. The clinical course is often sudden and is not preceded by any prodromal symptoms. Occurrence does not depend on the duration of hypoparathyroidism treatment, although it is closely related to the applied therapy, especially the dose of calcium carbonate and active vitamin D preparations. Read More

    Rapid whole genome sequencing identifies a novel AIRE variant associated with Autoimmune Polyendocrine Syndrome Type 1.
    Cold Spring Harb Mol Case Stud 2018 Feb 1. Epub 2018 Feb 1.
    Rady Children's Institute for Genomic Medicine.
    Autoimmune polyendocrine syndrome type 1 (APS1; OMIM #240300), also referred to as autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED), is a rare monogenic disorder caused by mutations in the autoimmune regulator (AIRE) gene. APS1 is classically characterized by a triad of chronic mucocutaneous candidiasis, autoimmune hypoparathyroidism, and autoimmune adrenocortical insufficiency. We report a five-year-old female who presented with symptoms of tetany due to hypocalcemia and was subsequently found to be secondary to hypoparathyroidism. Read More

    Evolution in the management of thyroid cancer: an observational study in two referral centres in Belgium.
    Acta Clin Belg 2018 Feb 12:1-5. Epub 2018 Feb 12.
    a Department of Endocrinology , University Hospitals Leuven , Leuven , Belgium.
    Objective Thyroid cancer incidence is increasing. The rise is most pronounced for microcancers (≤10 mm, T1a). In 2006, landmark European and American guidelines for the management of thyroid cancer were published. Read More

    Parathyroid autotransplantation in thyroid surgery.
    Langenbecks Arch Surg 2018 Feb 10. Epub 2018 Feb 10.
    Endocrine Surgery Unit, Hospital del Mar, Barcelona, Spain.
    Background: Careful parathyroid gland dissection and in situ preservation was the time-honored approach to prevent parathyroid failure after total thyroidectomy. The relative success of parathyroid autotransplantation of hyperplastic parathyroid tissue in patients with renal or hereditary hyperparathyroidism did popularize the use of normal parathyroid tissue autografts during thyroidectomy to prevent permanent hypoparathyroidism. Proof of autograft function in this setting, however, is controversial. Read More

    Randomized clinical trial of intraoperative parathyroid gland angiography with indocyanine green fluorescence predicting parathyroid function after thyroid surgery.
    Br J Surg 2018 Mar 6;105(4):350-357. Epub 2018 Feb 6.
    Department of Thoracic and Endocrine Surgery and Faculty of Medicine, University Hospitals of Geneva, Geneva, Switzerland.
    Background: Hypoparathyroidism, the most common complication after thyroid surgery, leads to hypocalcaemia and significant medical problems. An RCT was undertaken to determine whether intraoperative parathyroid gland angiography with indocyanine green (ICG) could predict postoperative hypoparathyroidism, and obviate the need for systematic blood tests and oral calcium supplementation.

    Methods: Between September 2014 and February 2016, patients who had at least one well perfused parathyroid gland on ICG angiography were randomized to receive standard follow-up (measurement of calcium and parathyroid hormone (PTH) on postoperative day (POD) 1 and systematic supplementation with calcium and vitamin D; control group) or no supplementation and no blood test on POD 1 (intervention group). Read More

    Isolated ligamentum flavum ossification in primary hypoparathyroidism.
    Surg Neurol Int 2018 10;9. Epub 2018 Jan 10.
    Department of Medicine, Aga Khan University, Karachi, Pakistan.
    Background: The ligamenta flava can undergo ossification and calcification resulting in myelopathy. Only seven cases of ligamentum flavum ossification in association with hypoparathyroidism have been reported, most of which had concurrent osseous changes in other spinal ligaments. Here, we report a patient with hypoparathyroidism who presented with ligamentum flavum ossification causing both cervical and thoracic myelopathy. Read More

    Does the number of parathyroid glands autotransplanted affect the incidence of hypoparathyroidism and recovery of parathyroid function?
    Surgery 2018 Feb 2. Epub 2018 Feb 2.
    Department of Thyroid Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. Electronic address:
    Background: The relationship between the number of parathyroid glands autotransplanted and hypoparathyroidism as well as recovery of parathyroid function is not understood fully. The aim was to ascertain whether the number of autotransplanted glands affected the incidence of hypoparathyroidism and recovery of parathyroid function in long-term follow-up after thyroidectomy.

    Methods: A retrospective cohort study included all patients with papillary thyroid carcinoma who underwent first-time total thyroidectomy with central neck dissection between June 2012 and June 2015. Read More

    A Systemic Review of Transoral Thyroidectomy.
    Surg Laparosc Endosc Percutan Tech 2018 Jan 31. Epub 2018 Jan 31.
    Thyroid Surgery, The Second Hospital of Shandong University, Jinan, Shandong, China.
    Background: Transoral thyroidectomy is a kind of "natural orifice transluminal endoscopic surgery (NOTES)" which is now being performed in increasing frequency. However, the safety and feasibility have not been concluded yet.

    Materials And Methods: A systemic literature search was performed in Pubmed, Cochrane, and Embase databases to identify all studies written in English and published up to April 2017. Read More

    Postoperative day 1 levels of parathyroid as predictor of occurrence and severity of hypocalcaemia after total thyroidectomy.
    Head Neck 2018 Feb 1. Epub 2018 Feb 1.
    Department of Otorhinolaryngology, University of Crete Medical School, Heraklion, Crete, Greece.
    Background: Hypocalcaemia is a common and serious complication after thyroidectomy. The purpose of this study is to assess the effectiveness of first postoperative day parathyroid hormone (PTH) measurement in order to predict the presence and severity of postthyroidectomy hypocalcaemia.

    Methods: One hundred consecutive cases undergoing total thyroidectomy in a tertiary referral center were prospectively assessed. Read More

    Postoperative hypoparathyroidism in patients after total thyroidectomy - retrospective analysis.
    Neuro Endocrinol Lett 2017 Dec;38(7):488-494
    Department of Endocrinology and Metabolic Diseases, Polish Mother's Memorial Hospital - Research Institute, Lodz, Poland.
    Objectives: Hypoparathyroidism is the most frequent complication of thyroidectomy. The incidence rates of temporary and permanent postoperative hypoparathyroidism vary from 7 to more than 60% and from 0 to 9%, respectively.

    Design: The aim of the study has been to evaluate the incidence of hypoparathyroidism and clinical manifestations of hypocalcaemia after total thyroidectomy, as well as assess factors that affect the frequency of the symptomatic hypocalcaemia, and benefits resulting from the measurement of parathyroid hormone (PTH) concentration on the first day after thyroidectomy. Read More

    Does hyperthyroidism worsen prognosis of thyroid carcinoma? A retrospective analysis on 2820 consecutive thyroidectomies.
    J Otolaryngol Head Neck Surg 2018 Jan 22;47(1). Epub 2018 Jan 22.
    Department of Surgical Sciences, University of Cagliari, Cittadella Universitaria, SS554, Bivio Sestu, 09042, Monserrato (CA), Italy.
    Background: Hyperthyroidism is associated with high incidence of thyroid carcinoma; furthermore, tumors arisen in hyperthyroid tissue show an aggressive behavior. Thyroid Stimulating Hormone (TSH) and Thyroid-stimulating antibodies, present in Graves's disease, seem to play a key role in carcinogenesis and tumoral growth.

    Methods: We retrospectively reviewed our series of patients who underwent thyroidectomy for thyroid carcinoma. Read More

    Novel method to save the parathyroid gland during thyroidectomy: Subcapsular saline injection.
    Head Neck 2018 Apr 22;40(4):801-807. Epub 2018 Jan 22.
    Department of Surgery, Seoul National University Hospital and College of Medicine, Jongno-gu, Seoul, Korea.
    Background: Saving the parathyroid gland during thyroidectomy remains challenging. Subcapsular saline injection (SCASI) was developed in February 2015. Its ability to spare the parathyroid gland was assessed. Read More

    An ICET- A survey on Hypoparathyroidism in Patients with Thalassaemia Major and Intermedia: A preliminary report.
    Acta Biomed 2018 Jan 16;88(4):435-444. Epub 2018 Jan 16.
    Quisisana Hospital, Ferrara.
    Hypoparathyroidism (HPT) is a rare disease with leading symptoms of hypocalcemia, associated with high serum phosphorus levels and absent or inappropriately low levels of parathyroid hormone (PTH). In patients with thalassemias it is mainly attributed to transfusional iron overload, and suboptimal iron chelation therapy. The main objectives of this survey were to provide data on the prevalence, demographic and clinical features of HPT in thalassemia major (TM) and intermedia (TI) patients living in different countries, and to assess its impact in clinical medical practice. Read More

    Postsurgical Outcomes and Surgical Completeness of Robotic Thyroid Surgery: A Single Surgeon's Experience on 700 Cases.
    J Laparoendosc Adv Surg Tech A 2018 Jan 18. Epub 2018 Jan 18.
    Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine , Seoul, Korea.
    Background: Advanced technology and understanding of robotic surgical system have rendered robotic thyroid surgery more expanding. The aim of this study was to identify the periodic changes in postsurgical outcomes of robotic thyroid surgery performed by a single surgeon.

    Methods: We conducted a retrospective review of 700 robotic thyroid surgery cases using gasless trans-axillary approach. Read More

    Developments in rare bone diseases and mineral disorders.
    Ther Adv Chronic Dis 2018 Jan 24;9(1):51-60. Epub 2017 Nov 24.
    University College Dublin, Belfield, Dublin, 4, Ireland.
    In the last decade, there have been a number of significant advances made in the field of rare bone diseases. In this review, we discuss the expansion of the classification system for osteogenesis imperfecta (OI) and the resultant increase in therapeutic options available for management of OI. Bisphosphonates remain the most widely used intervention for OI, although the effect on fracture rate reduction is equivocal. Read More

    Long-term outcome of prophylactic thyroidectomy in children carrying RET germline mutations.
    Br J Surg 2018 Jan;105(2):e150-e157
    Department of General, Visceral and Vascular Surgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
    Background: A comprehensive assessment has not been undertaken of long-term outcomes in children carrying germline RET mutations and undergoing prophylactic thyroidectomy with the aim of preventing medullary thyroid cancer (MTC).

    Methods: A retrospective outcome study (1994-2017) of prophylactic thyroidectomy in children, with and without central node dissection, was performed at a tertiary surgical centre.

    Results: Some 167 children underwent prophylactic thyroidectomy, 109 without and 58 with concomitant central node dissection. Read More

    Expanding indications of robotic thyroidectomy.
    Surg Endosc 2018 Jan 16. Epub 2018 Jan 16.
    Department of Surgery, Chung-Ang University Hospital and Chung-Ang University College of Medicine, 224-1, Heuk Seok-Dong, Dongjak-Ku, Seoul, 156-755, Republic of Korea.
    Background: Robotic thyroidectomy has many advantages with comparable oncologic safety over conventional open surgery in low-risk differentiated thyroid cancer cases. However, there have been few reports on the outcomes of patients who have been treated with robotic thyroidectomy for more advanced thyroid cancer. The aim of this study was to investigate the validity of expanding indications of robotic thyroidectomy for more advanced thyroid cancer. Read More

    The PGRIS and parathyroid splinting concepts for the analysis and prognosis of protracted hypoparathyroidism.
    Gland Surg 2017 Dec;6(Suppl 1):S86-S93
    Endocrine Surgery Unit, Hospital del Mar, Barcelona, Spain.
    Most patients with hypocalcemia after total thyroidectomy will recover the parathyroid function in a few weeks, but some 20-30% of them will still be in the need for replacement therapy one month after surgery and about 5-10% of those will develop permanent hypoparathyroidism. Although postoperative hypocalcemia has been related to several demographic and metabolic causes, parathyroid hormone (PTH) decline, resulting from autotransplantation, inadvertent excision or devascularization of the parathyroid glands, is the common final pathway. The number of parathyroid glands remaining in situ (PGRIS) is a key variable to understand the pathogenesis of protracted hypoparathyroidism and the chances for restoration of the parathyroid function. Read More

    Short and long-term impact of parathyroid autotransplantation on parathyroid function after total thyroidectomy.
    Gland Surg 2017 Dec;6(Suppl 1):S75-S85
    Endocrine Surgical Unit, University of Sydney, St Leonards, New South Wales, Australia.
    The most common complication of total thyroidectomy is parathyroid insufficiency. Acute, transient, post-operative hypoparathyroidism increases length of hospitalization, morbidity and cost associated with total thyroidectomy. While permanent hypoparathyroidism poses a significant medical burden with lifetime medication, regular follow up and considerable disease burden related to chronic renal failure and other sequelae. Read More

    Hypocalcaemia and permanent hypoparathyroidism after total/bilateral thyroidectomy in the BAETS Registry.
    Gland Surg 2017 Dec;6(Suppl 1):S69-S74
    Consultant Endocrine Surgeon, Nottingham University Hospitals, City Campus, Nottingham, UK.
    The UK Registry of Endocrine and Thyroid Surgeons (UKRETS) has been operated by the British Association of Endocrine and Thyroid Surgeons (BAETS) and Dendrite Clinical Systems Ltd. in a web-based electronic format since 2004. Data on over 90,000 endocrine procedures have been collected to date. Read More

    Incidence, prevalence and risk factors for post-surgical hypocalcaemia and hypoparathyroidism.
    Gland Surg 2017 Dec;6(Suppl 1):S59-S68
    Consultant Endocrine Surgeon, Endocrine Surgery Unit, Directorate of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
    Hypocalcaemia following thyroid surgery is common and is associated with significant short and long term morbidity. Damage to or devascularisation of parathyroid glands is the predominant underlying mechanism; although other factors such as hungry bone syndrome may occasionally contribute to it in the immediate post-operative period. The reported incidence of post-surgical hypocalcaemia and/or hypoparathyroidism (PoSH) varies significantly in the literature; the variation thought to be at least partly due to differences in the definitions used. Read More

    Less than total thyroidectomy for goiter: when and how?
    Gland Surg 2017 Dec;6(Suppl 1):S49-S58
    Division of Endocrine Surgery, Department of General Surgery, Ege University Hospital, Izmir, Turkey.
    Benign goiter is the most common endocrine disease that requires surgery, especially in endemic areas suffering from iodine-deficiency. Recent European and American guidelines recommended total thyroidectomy for the surgical treatment of multinodular goiter. Total thyroidectomy has now become the technique of choice and is widely considered the most reliable approach in preventing recurrence. Read More

    The role and timing of parathyroid hormone determination after total thyroidectomy.
    Gland Surg 2017 Dec;6(Suppl 1):S38-S48
    Section of Endocrine Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
    Postoperative hypocalcemia is a common complication of total thyroidectomy resulting from manipulation, resection, or devascularization of the parathyroid glands. Parathyroid hormone (PTH) levels assessed in the perioperative period have been used to predict development of hypocalcemia. Articles examining the role of PTH measurement in the perioperative period following total or completion thyroidectomy are reviewed. Read More

    A reappraisal of vascular anatomy of the parathyroid gland based on fluorescence techniques.
    Gland Surg 2017 Dec;6(Suppl 1):S30-S37
    Thoracic and Endocrine Surgery, University Hospitals of Geneva, Geneva, Switzerland.
    Identification of the parathyroid glands (PGs) during thyroid surgery may prevent their inadvertent surgical removal and prevent postoperative hypoparathyroidism. However, identification of the PGs does not guarantee their function, and their vascular supply needs to be preserved as well. The recent introduction of intraoperative indocyanine green (ICG) fluorescent angiography of the PGs during thyroid surgery allows for the appraisal of the vascular anatomy and evaluation of PG function. Read More

    To identify or not to identify parathyroid glands during total thyroidectomy.
    Gland Surg 2017 Dec;6(Suppl 1):S20-S29
    Department of Surgery, The University of Hong Kong, Hong Kong SAR, China.
    Hypoparathyroidism is one of the most common complications after total thyroidectomy and may impose a significant burden to both the patient and clinician. The extent of thyroid resection, surgical techniques, concomitant central neck dissection, parathyroid gland (PG) autotransplantation and inadvertent parathyroidectomy have long been some of the risk factors for postoperative hypoparathyroidism. Although routine identification of PGs has traditionally been advocated by surgeons, recent evidence has suggested that perhaps identifying fewer number ofPGs during surgery (i. Read More

    A nomogram to predict the likelihood of permanent hypoparathyroidism after total thyroidectomy based on delayed serum calcium and iPTH measurements.
    Gland Surg 2017 Dec;6(Suppl 1):S11-S19
    Endocrine Surgery Unit, University Hospital del Mar, Barcelona, Spain.
    Background: Retrospective studies have shown that delayed high-normal serum calcium and detectable iPTH are independent variables positively influencing outcome of prolonged parathyroid failure after total thyroidectomy (TT). The aim of the present study was to examine prospectively the ability of these two variables to predict permanent hypoparathyroidism in patients under replacement therapy for postoperative hypocalcemia.

    Methods: Prospective observational multicenter study of patients undergoing TT followed by postoperative parathyroid failure (serum calcium <8 mg/dL within 24 h and PTH <15 pg/mL 4 h after surgery). Read More

    Clinical profile and long-term follow-up of 32 patients with postoperative permanent hypoparathyroidism.
    Gland Surg 2017 Dec;6(Suppl 1):S3-S10
    Endocrine Surgery Unit, Hospital del Mar, Barcelona, Spain.
    Background: Parathyroid failure is the most common complication after total thyroidectomy but permanent impairment of the parathyroid function is unusual. Limited data is available assessing long-term follow-up, quality of life and complications occurring in patients with permanent hypoparathyroidism (PH). We aimed to assess the incidence of complications derived from PH status, their influence on the quality of life perceived by PH patients and its relation to standard medical treatment with calcium salts and active vitamin D analogues. Read More

    Does Surgery Without Lugol's Solution Pretreatment for Graves' Disease Increase Surgical Morbidity?
    World J Surg 2018 Jan 4. Epub 2018 Jan 4.
    The Department of Digestive and Endocrine Surgery, CHU Lyon Sud, Hospices Civils de Lyon, University of Lyon, 165 Chemin du Grand Revoyet, 69495, Pierre Bénite, France.
    Background: Total thyroidectomy can be performed for Graves' disease after a euthyroid state is achieved using inhibitors of thyroid hormone synthesis (thioamides). However, hypervascularization of the thyroid gland is associated with increased hemorrhage risk, in addition to complicating identification of the recurrent laryngeal nerve and parathyroid gland. Saturated iodine solution (Lugol's solution) has been recommended to reduce thyroid gland hypervascularization and intraoperative blood loss, although this approach is not used at our center based on our experience that it induces thyroid firmness and potentially hypoparathyroidism. Read More

    Effect of autotransplantation of a parathyroid gland on hypoparathyroidism after total thyroidectomy.
    Endocr Connect 2018 Feb 4;7(2):286-294. Epub 2018 Jan 4.
    Department of Thyroid Surgery, West China Hospital, Sichuan UniversityChengdu, China.
    Background: The effect of parathyroid autotransplantation on hypoparathyroidism is not fully understood. The purpose of the study was to determine the effect of autotransplantation of a parathyroid gland on the incidence of hypoparathyroidism and recovery of parathyroid function at 6 months after total thyroidectomy with central neck dissection for papillary thyroid carcinoma.

    Methods: All patients with autotransplantation of a parathyroid gland (no inadvertent parathyroidectomy) (group A),preservation of all parathyroid glands (no autotransplantation and inadvertent parathyroidectomy) (group B) or inadvertent removal of a parathyroid gland (no autotransplantation) (group C) who underwent first-time total thyroidectomy with central neck dissection for papillary thyroid carcinoma between January 2013 and June 2016 were included retrospectively. Read More

    Transcription factors that determine parathyroid development power PTH expression.
    Kidney Int 2018 Jan;93(1):7-9
    Hadassah Hebrew University Medical Center, Jerusalem, Ein Karem, Israel.
    Studies in patients with hypoparathyroidism and knockout mouse models have revealed key transcriptional cascades central for parathyroid organogenesis. Among the transcription factors essential for parathyroid development, Gata3, GCM2, and MafB, are expressed in the developing parathyroids as well as postnatally, implying that they also regulate parathyroid-specific gene expression and function in the adult. PTH gene expression is determined by transcriptional and posttranscriptional mechanisms. Read More

    Congenital respiratory tract disorders in 22q11.2 deletion syndrome.
    Int J Pediatr Otorhinolaryngol 2018 Jan 20;104:1-4. Epub 2017 Oct 20.
    Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, Utrecht University, The Netherlands; Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands.
    Objective: Respiratory tract disorders have been reported in patients with 22q11.2 deletion syndrome, however infrequently. This study describes the respiratory tract disorders encountered in a cohort of 278 patients with 22q11. Read More

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