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Impact of rocuronium on intraoperative neuromonitoring vagal amplitudes during thyroidectomy.

Langenbecks Arch Surg 2021 Jun 12. Epub 2021 Jun 12.

Department of Surgery (CVMC), Unit of Metabolic, Endocrine, and Thyroid Surgery, Université de Lorraine, CHRU Nancy-Brabois (7Eme Étage), Vandœuvre-lès-Nancy, France.

Purpose: Neuromuscular blocking agents (NMBA) facilitate endotracheal intubation and reduce related laryngeal morbidity. However, NMBA interfere with intraoperative neuromonitoring amplitudes during thyroidectomy. The goal of this study was to evaluate the impact of rocuronium used for tracheal intubation on early intraoperative neuromonitoring vagal amplitudes observed during first thyroid lobe dissection. Read More

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Application of lateral supraclavicular incision in unilateral thyroid papillary carcinoma surgery.

Braz J Otorhinolaryngol 2021 Apr 20. Epub 2021 Apr 20.

Kunming Medical University, Third Affiliated Hospital, Kunming, Yunnan Province, China. Electronic address:

Introduction: The standard approach to thyroidectomy is a collar incision via the anterior neck, and the neck scar has always been a source of worry for patients. Acceptable wound cosmetology has become a focus for thyroid surgeons.

Objective: To verify the effectiveness and cosmetic results of thyroidectomy through a lateral supraclavicular incision. Read More

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Higher EU-TIRADS-Score Correlated with BRAF V600E Positivity in the Early Stage of Papillary Thyroid Carcinoma.

J Clin Med 2021 May 25;10(11). Epub 2021 May 25.

Department of Oncological Endocrinology and Nuclear Medicine, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland.

The data demonstrating a correlation between sonographic markers of malignancy of thyroid cancer (TC) and its genetic status are scarce. This study aimed to assess whether the addition of genetic analysis at the preoperative step of TC patients' stratification could aid their clinical management. The material consisted of formalin-fixed paraffin-embedded tumor fragments of 49 patients who underwent thyroidectomy during the early stages of papillary TC (PTC). Read More

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Analysis of Risk Factors for Surgical Complications of Endoscopic Thyroidectomy via Total Areola Approach.

Cancer Manag Res 2021 18;13:4003-4012. Epub 2021 May 18.

Department of General Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China.

Background: Increased surgical technology has led broad acceptance endoscopic thyroidectomy and its application in the treatment of thyroid diseases, including thyroid carcinoma. Although the incidence of complications and mortality of thyroid surgery has been significantly reduced, serious complications still occur from time to time. The purpose of this retrospective study is to identify the factors that influence the complications of endoscopic thyroidectomy. Read More

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Papillary thyroid microcarcinoma: is active surveillance always enough?

Clin Endocrinol (Oxf) 2021 May 21. Epub 2021 May 21.

Department of Endocrinology and Diabetes, Royal North Shore Hospital Sydney, Australia.

The incidence of papillary thyroid carcinoma (PTC) has increased over recent decades. This apparent epidemic has been attributed to the overdiagnosis of small PTC ≤ 10mm in diameter (PTMC) incidentally detected on imaging for unrelated presentations. While most PTMC follow an indolent disease course, there is a small but significant proportion of cases that display more biologically aggressive features such as early metastasis and lymph node involvement. Read More

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How to identify indolent thyroid tumors unlikely to recur and cause cancer death immediately after surgery-Risk stratification of papillary thyroid carcinoma in young patients.

Endocr J 2021 May 11. Epub 2021 May 11.

Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Current histopathological diagnosis methods cannot distinguish the two types of thyroid carcinoma: clinically significant carcinomas with a potential risk of recurrence, metastasis, and cancer death, and clinically insignificant carcinomas with a slow growth rate. Both thyroid tumors are diagnosed as "carcinoma" in current pathology practice. The clinician usually recommends surgery to the patient and the patient often accepts it because of cancer terminology. Read More

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Patient tailored levothyroxine dosage with pharmacokinetic/pharmacodynamic modeling: a novel approach after total thyroidectomy.

Thyroid 2021 May 12. Epub 2021 May 12.

SINTEF, 6298, Dept Sustainable Energy Technology, Trondheim, Norway;

Background After seven decades of levothyroxine replacement therapy, dosage adjustment still takes several months. We have developed a decision aid tool (DAT) that models levothyroxine pharmacometrics and enables patient tailored dosage. The aim was to speed up dosage adjustments for patients after total thyroidectomy. Read More

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Influence of Recurrent Laryngeal Nerve Transient Unilateral Palsy on Objective Voice Parameters and on Voice Handicap Index after Total Thyroidectomy (Including Thyroid Carcinoma).

Int J Environ Res Public Health 2021 04 18;18(8). Epub 2021 Apr 18.

Department of Otorhinolaryngology and Maxillofacial Surgery, Military University Hospital, 16902 Prague, Czech Republic.

Total thyroidectomy (TT) is one of the most common surgical endocrine surgeries. Voice impairment after TT can occur not only in patients with recurrent laryngeal nerve (RLN) transient paralysis, but also in cases of normal vocal cord mobility. To compare voice limits using a speech range profile (SRP) in patients before and 14 days after TT and to investigate the influence of the early results of voice quality after TT on the personal lives of patients. Read More

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Nonfunctional parathyroid cancer a case report.

Rozhl Chir 2021 ;100(3):133-137

Introduction: Parathyroid cancer is a rare endocrine malignancy. These tumors are typically functional, causing severe hypercalcemia due to primary hyperparathyroidism. Nonfunctional parathyroid cancer with normal serum calcium and parathyroid hormone levels is extremely rare. Read More

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Morbidity and mortality associated with thyroid surgery - retrospective analysis 19912010.

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

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The role of early postoperative parathyroid hormone level after total thyroidectomy in prediction of hypocalcemia.

Ann Med Surg (Lond) 2021 May 29;65:102252. Epub 2021 Mar 29.

Department of Surgery, College of Medicine, University of Duhok, Azadi Teaching Hospital & Duhok Kidney Dis. Center, Duhok, Kurdistan Region, Iraq.

Background: Estimation of parathyroid hormone (PTH) after thyroid surgery helps to predict the development of hypocalcemia and allows early intervention and management with oral calcium and/or vitamin D supplementation in the postoperative period.

Patients And Methods: This retrospective study included 57 patients who underwent total or completion thyroidectomy within 4 years. Measurement of serum PTH level was done 3 h after surgery for its change and prediction of hypocalcemia. Read More

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Measuring neck circumference to predict and detect haemorrhage following thyroid surgery. A case series and literature review.

J Surg Case Rep 2021 Apr 19;2021(4):rjab089. Epub 2021 Apr 19.

General and Minimal Invasive Surgery, Faculty of Medicine, Alexandria University, Egypt.

Post-thyroidectomy bleeding is a fortunately rare but potentially life-threatening complication that may increase postoperative morbidity and hospital stay. In this case series, we demonstrate the relation between the measurement of neck circumference and haemorrhage following thyroid surgery and the value of this measurement in predicting post-thyroidectomy haemorrhage. Currently, there is no simple and reliable method available for the early detection of post-thyroidectomy bleeding. Read More

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Solitary thyroid metastasis from colorectal cancer: Case report.

Authors:
Hwansoo Kim

Int J Surg Case Rep 2021 Apr 22;81:105804. Epub 2021 Mar 22.

Department of Surgery, Kangwon National University Hospital, Kangwon National University Hospital, 156, Baengnyeong-ro, Chuncheon-Si, Gangwon-Do 24289, Republic of Korea. Electronic address:

Introduction And Importance: Thyroid metastasis of colorectal cancer is rare and the patient with thyroid metastasis has no symptoms early in the disease course. On the other hand, evaluation of thyroid is not generally included in the routine follow-up of colorectal cancer. Therefore, the diagnosis of thyroid metastasis of colorectal cancer may be delayed. Read More

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The Clinical Spectrum of PTEN Hamartoma Tumor Syndrome: Exploring the Value of Thyroid Surveillance.

Horm Res Paediatr 2020 22;93(11-12):634-642. Epub 2021 Apr 22.

Division of Endocrinology and Diabetes, The Thyroid Center, Children's Hospital of Philadelphia, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Introduction: Phosphatase and tensin homolog (PTEN) hamartoma tumor syndrome (PHTS) comprises a collection of clinical features characterized by constitutional variants in PTEN. Several guidelines recommend thyroid screening, beginning at the pediatric age at the time of PHTS diagnosis; however, the benefits of early surveillance has not been well defined.

Methods: We conducted a retrospective investigation of patients followed up at the Children's Hospital of Philadelphia with a diagnosis of PHTS between January 2003 and June 2019. Read More

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Total Thyroidectomy vs Thyroid Lobectomy for Localized Papillary Thyroid Cancer in Children: A Propensity-Matched Survival Analysis.

J Am Coll Surg 2021 Apr 3. Epub 2021 Apr 3.

Section of Endocrine Surgery, Department of Surgery, University of Chicago Medicine. Chicago IL USA.

Introduction: Current guidelines recommend total thyroidectomy (TT) and radio-ablation for most papillary thyroid cancer (PTC) in children. These guidelines have been criticized as aggressive, especially for early-stage PTC, as it likely does not influence patient survival and results in life-long thyroid hormone replacement. We sought to study whether the extent of thyroidectomy (TT vs. Read More

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Predictive factors for prolonged operative time of robotic thyroidectomy via bilateral axillo-breast approach: Analysis of 359 cases of differentiated thyroid cancer.

Asian J Surg 2021 Apr 17. Epub 2021 Apr 17.

Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, PR China. Electronic address:

Objective: This study assessed the results of robotic thyroidectomy for differentiated thyroid cancer in early stage, to identify the predictive factors of operative time and complication rate.

Methods: A patient cohort of 359 cases in total was involved in this retrospective study. The data of clinical characteristics and follow-up results were collected. Read More

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Diagnostic Challenges of Medullary Thyroid Carcinoma.

Oncology 2021 Apr 20:1-11. Epub 2021 Apr 20.

Division of Endocrinology, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.

Background: Medullary thyroid carcinoma (MTC) comprises 1-2% of all thyroid cancers, yet 15% of all thyroid cancer-related deaths. While up to 20% of cases may be predicted due to autosomal dominant germline mutations, 80% of cases are sporadic. However, due to non-specific presenting symptoms and diagnostic imaging, prompt diagnosis and treatment has remained elusive. Read More

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Lessons Learned after Iatrogenic Complete Transection of the Right Common Carotid Artery with Segmental Vessel Loss.

Case Rep Vasc Med 2021 27;2021:8812870. Epub 2021 Mar 27.

Department of Surgery, Port of Spain General Hospital, West Indies, Trinidad and Tobago.

Carotid arterial injuries occur in 5-6% of persons with penetrating trauma. Complete transection is rare in civilian practice and is most often due to penetrating injuries. Complete transection as an iatrogenic complication is rare. Read More

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Transoral endoscopic vestibular approach for thyroidectomy and parathyroidectomy - From promise to practice.

Am J Otolaryngol 2021 Mar 31;42(5):103022. Epub 2021 Mar 31.

A.R.M. Center of Otolaryngology Head and Neck Surgery, Assuta Medical Center, Tel Aviv, Israel.

Objectives: To describe the evolution and recent series on transoral endoscopic vestibular approach thyroidectomy and parathyroidectomy (TOET/PVA).

Data Sources: PubMed, Google Scholar.

Review Methods: Review of the available English literature. Read More

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Effect of low-concentration carbohydrate on patient-centered quality of recovery in patients undergoing thyroidectomy: a prospective randomized trial.

BMC Anesthesiol 2021 Apr 6;21(1):103. Epub 2021 Apr 6.

Department of Anesthesiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, Sichuan, China.

Backround: At present, low-concentration carbohydrate is rarely used in minor trauma surgery, and its clinical efficacy is unknown. The aim of the study was to evaluate the effect of preoperative oral low-concentration carbohydrate on patient-centered quality of recovery in patients undergoing thyroidectomy using Quality of Recovery - 15 (QoR-15) questionnaire.

Methods: One hundred twenty patients were randomized to oral intake of 300 ml carbohydrate solution (CH group) or 300 ml pure water (PW group) 2 h before surgery or fasting for 8 h before surgery (F group). Read More

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Can shear wave elastography determine remnant thyroid tissue in the early postoperative period in patients with differentiated thyroid carcinoma?

J Ultrasound 2021 Apr 5. Epub 2021 Apr 5.

Department of Radiology, Faculty of Medicine, Selçuk University, Ardıclı Mahallesi, Celal Bayar Cad. No:313, 42250, Selçuklu, Konya, Turkey.

Purpose: This study aims to investigate the usability of ultrasonography (US) and shear wave elastography (SWE) in detecting remnant thyroid tissue (RTT) within the first three postoperative months in patients who underwent total thyroidectomy (TT) for differentiated thyroid cancer (DTC) and who were scheduled for radioiodine (RAI) ablation therapy.

Methods: Sixty-nine patients who underwent a TT operation due to DTC were included in the study. The participant's thyroid surgical bed was first evaluated by thyroid scintigraphy and then by greyscale US and SWE to investigate RTT. Read More

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Management and results of thyroidectomies in pediatric patients with men 2 syndrome.

J Pediatr Surg 2021 Mar 3. Epub 2021 Mar 3.

Department of Pediatric Surgery, Gregorio Marañón University Hospital Máiquez Street N 9, 28007 Madrid, Spain.

Aim Of The Study: To evaluate the outcome of prophylactic thyroidectomies (PT) in patients with MEN 2 syndrome in a tertiary center.

Methods: A retrospective study was designed, including all patients with MEN 2 syndrome who underwent PT between 2000 and 2019. Demographics, gene mutation, postoperative complications and histopathological findings were registered. Read More

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Advancements in the treatment of differentiated thyroid cancer.

Ther Adv Endocrinol Metab 2021 17;12:20420188211000251. Epub 2021 Mar 17.

Department of Endocrine Surgery, Columbia University, 161 Fort Washington Ave, 8th Floor, New York, NY 10032, USA.

Derived from follicular epithelial cells, differentiated thyroid cancer (DTC) accounts for the majority of thyroid malignancies. The threefold increase in DTC incidence over the last three decades has been largely attributed to advancements in detection of papillary thyroid microcarcinomas. Efforts to address the issue of overtreatment have notably included the reclassification of encapsulated follicular variant papillary thyroid cancers (EFVPTC) to non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Read More

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Radioiodine Remnant Ablation for Differentiated Thyroid Cancer: A Systematic Review and Meta-analysis.

JAMA Otolaryngol Head Neck Surg 2021 Jun;147(6):544-552

Department of Surgery, Galway University Hospitals, Galway, Ireland.

Importance: Postoperative radioactive iodine (RAI) remnant ablation for differentiated thyroid cancer (DTC) facilitates the early detection of recurrence and represents an adjuvant therapy that targets persistent microscopic disease. The optimal activity of RAI in low- and intermediate-risk DTC remains controversial.

Objective: To evaluate the long-term cure rate of different RAI activities in low- and intermediate-risk DTC. Read More

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Calcitonin-Negative Neuroendocrine Carcinoma of the Thyroid Gland: Case Report and Literature Review.

Case Rep Oncol 2021 Jan-Apr;14(1):112-122. Epub 2021 Mar 1.

Department of Surgery Oncology, Medica Sur Clinic & Foundation, Mexico, Mexico.

Calcitonin-negative neuroendocrine tumor (CNNET) of the thyroid is an extremely rare entity. In some of the previously reported cases within the literature, the terms "atypical medullary thyroid carcinoma," "calcitonin-free oat cell carcinoma," and "a distinct clinical entity" were applied to NETs without definitive evidence of calcitonin production. In the English-language literature, not only are there only few reported cases of CNNET, but the criteria for diagnosis in these cases are also controversial. Read More

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The Clinical and Pathological Characteristics of Malignant Struma Ovarii: An Analysis of 144 Published Patients.

Front Oncol 2021 5;11:645156. Epub 2021 Mar 5.

Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Institute of Nephrology, Jinan, China.

The objective of this study is to summarize the clinical and pathologic characteristics of malignant struma ovarii to facilitate the early diagnosis and treatment of this disease. All 144 patients were females from 27 countries. The mean age of the patients at diagnosis was 42. Read More

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Controversy: For or against thyroid lobectomy in>1cm differentiated thyroid cancer?

Ann Endocrinol (Paris) 2021 Apr 20;82(2):78-82. Epub 2021 Mar 20.

Department of endocrine surgery, Hôpital Lyon Sud, 165, rue du grand Revoyet, 69495 Pierre-Bénite, France; Inserm U1290, Research on Healthcare Performance Lab (RESHAPE), Université Claude-Bernard Lyon 1, domaine Rockefeller, 8, avenue Rockefeller, 69003 Lyon, France. Electronic address:

In this controversy article, the respective advantages of lobectomy vs. total thyroidectomy in differentiated thyroid cancers are argued. The authors conclude that lobectomy has the same oncological prognosis as thyroidectomy in terms of specific survival or recurrence, in case of low risk of recurrence (T1-2N0). Read More

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Scar satisfaction assessment after conventional thyroidectomy: follow-up results.

Acta Otorhinolaryngol Ital 2021 Feb;41(1):39-42

Department of Endocrine Surgery, Baby Memorial Hospital, Kozhikode, Kerala, India 673004.

Objective: With the introduction of remote access thyroidectomy questions regarding patient satisfaction after trans-cervical thyroidectomy has been raised in several publications. As far as neck scars are concerned, patient satisfaction in the early post-operative period and long term are different. This study assessed patient satisfaction regarding their neck scar in the early post-operative period and at long term follow-up. Read More

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February 2021

Quantitative dual isotope iodine/Tc-MIBI scintigraphy: A new approach to rule out malignancy in thyroid nodules.

Ann Endocrinol (Paris) 2021 Apr 13;82(2):83-91. Epub 2021 Mar 13.

Department of Endocrinology, Diabetology, and Metabolism, Lille University Hospital, Lille, France; Department of Endocrinology, Valenciennes General Hospital, Valenciennes, France.

Background: The aim of this study was to evaluate the role of dual isotope Iodine/Tc-MIBI thyroid scintigraphy (IMS) in discriminating between malignant and benign lesions in indeterminate nodules using quantitative analysis methods.

Methods: Thirty-five consecutive patients with thyroid nodules of indeterminate or non-diagnostic cytology and cold on Iodine scintigraphy (10 Bethesda I, 24 Bethesda III-IV, 1 in which cytology was impossible) underwent IMS between 2017 and 2019 with uptake quantification at two time points ahead of thyroidectomy: early and late. Images were analyzed by two blinded physicians. Read More

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Optimal Timing of Initiating Dynamic Risk Stratification During the Early Postoperative Period in Patients with Differentiated Thyroid Carcinoma After Thyroidectomy and Radioactive Iodine Remnant Ablation.

Ann Surg Oncol 2021 Mar 6. Epub 2021 Mar 6.

Department of Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea.

Background: This study investigated the optimal timing to initiate assessment of the response to initial therapy during the early postoperative period in patients with differentiated thyroid carcinoma (DTC) using dynamic risk stratification (DRS).

Methods: This historical cohort study included 510 patients with DTC who underwent a total thyroidectomy followed by radioactive iodine (RAI) remnant ablation. DRS for these patients was categorized into subgroups according to the time into the follow-up period at which the response to initial therapy was assessed. Read More

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