Thyroidectomy and Neck Exploration: New Surgical Approaches

2016 ◽  
pp. 249-266 ◽  
Keyword(s):  
Neck Exploration ◽  
Surgical Approaches

Hypocalcemia after Neck Exploration for Untreated Primary Hyperparathyroidism

2006 ◽  
Vol 72 (12) ◽  
pp. 1234-1237 ◽  
Author(s):  
C. Adam Conn ◽  
Jonathan Clark ◽  
Jeffrey Bumpous ◽  
Richard Goldstein ◽  
Muffin Fleming ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Primary Hyperparathyroidism ◽  
Postoperative Management ◽  
Bilateral Neck Exploration ◽  
Neck Exploration ◽  
Surgical Approaches ◽  
Postoperative Hypocalcemia ◽  
Duration Of Surgery ◽  
University Of Louisville ◽  
The University

Hypocalcemia after neck exploration for hyperparathyroidism is an important postoperative management issue. With increasing acceptance of less invasive surgical approaches, hypocalcemia is less frequent. This study was conducted to evaluate postoperative hypocalcemia after current surgical exploration techniques in patients with untreated primary hyperparathyroidism. From the University of Louisville parathyroid database, charts of patients undergoing surgery for untreated primary hyperparathyroidism from May 1, 1998 to May 30, 2004 were reviewed. Data was analyzed based on age, sex, preoperative calcium and parathyroid hormone levels, preexisting diseases, and extent of neck exploration. One hundred sixty-nine patients were identified with adequate data for analysis. Transient postoperative hypocalcemia occurred in 21 per cent (36/169) for the total group, in 18 per cent (22/125) after minimally invasive radio-guided parathyroidectomy, and in 32 per cent (14/44) after bilateral neck exploration. Patients with postoperative hypocalcemia had a statistically significant association with older age and pre-existing hypertension. Patients with postoperative hypocalcemia were more likely to have undergone longer surgical procedures and were more likely to have had pre-existing diabetes and mental disorders. These findings were not statistically significant and were considered trends. The frequency of osteoporosis in the hypocalcemia group was increased but was not significant. Transient hypocalcemia occurred in 21 per cent of patients after parathyroid surgery. It was more likely after bilateral neck exploration, a longer duration of surgery, and with hypertension, diabetes, and mental disorders.

Surgical Approaches to the Brain Stem

1993 ◽  
Vol 4 (3) ◽  
pp. 457-468 ◽  
Author(s):  
Dennis Y. Wen ◽  
Roberto C. Heros
Keyword(s):  
Brain Stem ◽  
Surgical Approaches ◽  
The Brain

Current Strategies in the Management of Spinal Metastatic Disease

Swiss Surgery ◽  
2003 ◽  
Vol 9 (2) ◽  
pp. 55-62 ◽  
Author(s):  
Bartanusz ◽  
Porchet
Keyword(s):  
Spinal Cord ◽  
Surgical Techniques ◽  
Cord Compression ◽  
Treatment Modalities ◽  
Surgical Approaches ◽  
Spinal Stabilization ◽  
Management Algorithm ◽  
Specific Manner ◽  
Extensive Surgery ◽  
Selection Of

The treatment of metastatic spinal cord compression is complex. The three treatment modalities that are currently applied (in a histologically non-specific manner) are surgery, radiotherapy and the administration of steroids. The development of new spinal instrumentations and surgical approaches considerably changed the extent of therapeutic options in this field. These new surgical techniques have made it possible to resect these tumours totally, with subsequent vertebral reconstruction and spinal stabilization. In this respect, it is important to clearly identify those patients who can benefit from such an extensive surgery. We present our management algorithm to help select patients for surgery and at the same time identifying those for whom primary non-surgical therapy would be indicated. The retrospective review of surgically treated patients in our department in the last four years reveals a meagre application of conventional guidelines for the selection of the appropriate operative approach in the surgical management of these patients. The reasons for this discrepancy are discussed.

Surgical Approaches to the Suprasellar Infrachiasmatic Region: Comparison among Pterional, Subfrontal, and Endoscopic Endonasal Approaches

2013 ◽  
Vol 74 (S 01) ◽  
Author(s):  
Francisco A. Filho ◽  
Rodrigo Cavalcante ◽  
Milton Rastelli ◽  
Omar Ramirez ◽  
Alessandro Paluzzi ◽  
...  
Keyword(s):  
Surgical Approaches ◽  
Endoscopic Endonasal

Factors Predicting Recurrence after Resection of Clival Chordoma using Variable Surgical Approaches and Radiation Modalities

2015 ◽  
Vol 76 (S 01) ◽  
Author(s):  
Arman Jahangiri ◽  
Aaron Chin ◽  
Jeffrey Wagner ◽  
Sandeep Kunwar ◽  
Christopher Ames ◽  
...  
Keyword(s):  
Surgical Approaches ◽  
Clival Chordoma

Different Surgical Approaches to the Orbit

Skull Base ◽  
2007 ◽  
Vol 17 (S 1) ◽  
Author(s):  
U. Schick
Keyword(s):  
Surgical Approaches

Surgical Approaches and Techniques for Tuberculum Sellae Meningiomas

Skull Base ◽  
2008 ◽  
Vol 18 (S 01) ◽  
Author(s):  
Jiankang Shen ◽  
Weiguo Zhao ◽  
Liuguan Bian ◽  
Yu Cai
Keyword(s):  
Surgical Approaches ◽  
Tuberculum Sellae

Comparison of Fibrinolytic versus Surgical Therapy in the Treatment of Obstructive Prosthetic Valve Thrombosis: A Single-Center Experience

2011 ◽  
Vol 14 (2) ◽  
pp. 87 ◽  
Author(s):  
Necip Ermis ◽  
Hakan Atalay ◽  
Hakan Altay ◽  
Muhammet Bilgi ◽  
Suleyman Binici ◽  
...  
Keyword(s):  
New York ◽  
Prosthetic Heart Valve ◽  
Heart Association ◽  
International Normalized Ratio ◽  
Fibrinolytic Therapy ◽  
Surgical Approaches ◽  
Specific Patient ◽  
Single Center Experience ◽  
Surgery Group ◽  
Valve Thrombosis

Objective: Prosthetic heart valve thrombosis (PVT) is a rare but severe cardiac condition. There are only a few data regarding comparison of the fibrinolytic and surgical approaches for the treatment of PVT. In this study, we compared the results of fibrinolytic therapy versus surgery in patients who presented to our institution with a diagnosis of obstructive-type PVT.Methods: From January 2001 to August 2008 in our institution, 33 patients who met clinical and echocardiographic criteria for obstructive-type PVT were included in the study. Fifteen of these patients underwent fibrinolytic treatment with streptokinase, which consisted of an initial bolus of 250,000 U followed by 100,000 U/h. Eighteen patients were treated with surgery.Results: The 2 groups had similar baseline characteristics, including New York Heart Association functional status, types and positions of prosthetic valves, international normalized ratio values, and presentation symptoms. Full hemodynamic success was achieved in 12 patients who underwent fibrinolytic therapy and in 15 patients in the surgery group. The mean (SD) streptokinase infusion time was 17.8 11.1 hours. Two major hemorrhages and 2 cases of systemic embolism were observed in the fibrinolytic group. The 2 groups did not differ with respect to mortality rate (P = .79). The duration of hospitalization was longer in the fibrinolytic group than in the surgery group (10.7 6.6 days versus 6.9 6.7 days, P = .045).Conclusions: Although fibrinolytic therapy is generally recommended for the treatment of PVT for specific patient groups, our results suggest that it may be as efficacious and safe as surgery, depending on patient selection.

Surgical Approaches in Fulminant Ulcerative Colitis

2012 ◽  
Vol 3 (5) ◽  
pp. 115-117
Author(s):  
Corina Silvia Pop ◽  
◽  
Roxana Maria Nemes ◽  
George Pariza
Keyword(s):  
Ulcerative Colitis ◽  
Surgical Approaches ◽  
Fulminant Ulcerative Colitis
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