scholarly journals Total thyroidectomy for non-toxic multinodular goiter with versus without the use of harmonic FOCUS dissecting shears – a prospective randomized study

2012 ◽  
Vol 4 ◽  
pp. 268-274 ◽  
Author(s):  
Aleksander Konturek ◽  
Marcin Barczyński ◽  
Małgorzata Stopa ◽  
Wojciech Nowak
Keyword(s):  
Total Thyroidectomy ◽  
Multinodular Goiter ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Harmonic Focus ◽  
Toxic Multinodular Goiter

scholarly journals Harmonic focus in total thyroidectomy plus level III-IV and VI dissection: a prospective randomized study

2011 ◽  
Vol 9 (1) ◽  
Author(s):  
Qingqing He ◽  
Dayong Zhuang ◽  
Luming Zheng ◽  
Peng Zhou ◽  
Jixin Chai ◽  
...  
Keyword(s):  
Total Thyroidectomy ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Harmonic Focus

scholarly journals Is the superior laryngeal nerve really safe when using harmonic focus in total thyroidectomy? A prospective randomized study

2018 ◽  
Vol 41 (3) ◽  
pp. 222-228 ◽  
Author(s):  
Kemal Arslan ◽  
Bulent Erenoglu ◽  
Osman Dogru ◽  
Gultekin Ovet ◽  
Ersin Turan ◽  
...  
Keyword(s):  
Total Thyroidectomy ◽  
Randomized Study ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Prospective Randomized Study ◽  
Harmonic Focus

Major post-operative complications of thyroid surgery: Preventable or not?

2009 ◽  
Vol 34 (3) ◽  
pp. 99-103 ◽  
Author(s):  
M.A. Majid ◽  
Md. Ibrahim Siddique
Keyword(s):  
Total Thyroidectomy ◽  
Vocal Cord ◽  
Thyroid Surgery ◽  
Multinodular Goiter ◽  
Vocal Cord Palsy ◽  
Subtotal Thyroidectomy ◽  
Permanent Hypoparathyroidism ◽  
Respiratory Obstruction ◽  
Operative Complications ◽  
Toxic Multinodular Goiter

Factors responsible for major complications following thyroid surgery in 598 patients were studied. Patients with non toxic multinodular goiter involving both lobes of thyroid constituted the maximum bulk subjected to thyroidectomy. The most frequent procedure was bilateral subtotal thyroidectomy. Reactionary hemorrhage occurred in 6 patients, all following bilateral procedures and among them 5 patients developed tension hematoma with respiratory obstruction despite the presence of a drain. Temporary vocal cord palsy was observed in 7 patients whereas one patient subjected to total thyroidectomy with neck dissection for papillary carcinoma of thyroid developed permanent right vocal cord palsy. Temporary parathyroid insufficiency was seen in 51 patients and one patient developed permanent hypoparathyroidism. Incidence of parathyroid insufficiency was higher in bilateral procedures as compared to unilateral ones. There was no operation related death in this series, but complications like hemorrhage, vocal cord palsy and parathyroid insufficiency following thyroid surgery are still a deep concern. Keywords: Complication; Post-operative; Thyroid surgeryOnline: 29-1-2009DOI: 10.3329/bmrcb.v34i3.1973     Bangladesh Med Res Counc Bull 2008; 34: 99-103. 

scholarly journals Malignancy in Clinically Non-toxic Multinodular Goiter

2021 ◽  
Vol 10 (1-2) ◽  
pp. 84-88
Author(s):  
Mohd Shahjahan Ali ◽  
Md Habibullah Sarkar ◽  
Syeda Momena Hossain
Keyword(s):  
Total Thyroidectomy ◽  
Multinodular Goiter ◽  
Histopathological Examination ◽  
Follicular Adenoma ◽  
Cervical Lymphadenopathy ◽  
Follicular Carcinoma ◽  
Chronic Thyroiditis ◽  
College Hospital ◽  
Toxic Multinodular Goiter ◽  
Thyroid Swelling

Objective: Goiter is a common form of thyroid swelling among population living in areas of iodine deficiency. Of the goiters, non-toxic multinodular goiter (MNG) is the most common and benign form of thyroid disease. However, studies have shown that long-standing MNGs may harbour malignancy. The present study was, therefore, undertaken to ascertain the prevalence of malignancy in clinically diagnosed non-toxic MNGs. Methods: This cross-sectional study was conducted in the Department of Surgery (all four-units) and ENT Department, Rajshahi Medical College Hospital, Rajshahi from July 2007 to June 2008 on 100 patients of clinically non-toxic MNG who underwent thyroid surgery. Biopsy materials were taken from the excised nodules and were sent for histopathological examination to see what proportion of them harboured malignancy. Result: The findings of the study showed that 40% of patients were 30-40 years old with mean age of the patients being 35.5 ± 10.1 (range: 14-75) years. Majority (87%) of the patients was female. Half of the patients with non-toxic MNGs had a history of thyroid swelling for 1-5 years and the rest half for > 5 years with median duration of illness being 5.5 years (range: 1-30 years). Of the 100 patients 4% had stridor and 6% dyspnoea; dysphagia and cervical lymphadenopathy each was 6%. Nearly 60% of the patients had goiter of size 15 sq-cm or below. Sub-total thyroidectomy was the most common operation performed (33%) followed by right hemi-thyroidectomy (24%), near total thyroidectomy (20%), left hemi-thyroidectomy (18%) and total thyroidectomy (5%). Histopathological examination of resected specimens revealed that 15% of the MNGs had malignancy with papillary to follicular carcinoma ratio being 4:1. Histopathological typing showed that 79% was simple MNGs, 4% follicular adenoma, 12% papillary carcinoma, 3% follicular carcinoma and 2% chronic thyroiditis. Neither age nor sex was found to be associated with presence of malignancies in MNGs (p = 0.865 and p = 0.647 respectively). The goiter-size was also not associated with presence of malignancies (p = 0.691). However, the mean duration of thyroid swelling in patients who had malignancy was much higher (8.5 years) than that in patients who did not haveany malignancy (5.7 years) (p = 0.024). Conclusion: The study concluded that a small proportion of long-standing non-toxic MNGs may turn into malignancy. Therefore, routine operative treatment without confirming that the cases are malignant does not seem to be justified. Ibrahim Card Med J 2020; 10 (1&2): 84-88

scholarly journals Surgical Management of Toxic Multinodular Goiter

2011 ◽  
Vol 3 (2) ◽  
pp. 69-73
Author(s):  
Antoine Digonnet ◽  
Esther Willemse ◽  
Cécile Dekeyser ◽  
Nicolas de Saint Aubain ◽  
Moreau Michel ◽  
...  
Keyword(s):  
Total Thyroidectomy ◽  
Vocal Cord ◽  
Multinodular Goiter ◽  
Vocal Cord Palsy ◽  
Primary Treatment ◽  
Definitive Treatment ◽  
Large Goiter ◽  
Appropriate Treatment ◽  
Tertiary Center ◽  
Toxic Multinodular Goiter

ABSTRACT Management of toxic multinodular goiter (TMNG) is still debated. We report our current experience with thyroidectomy for toxic multinodular goiter at a tertiary center. A retrospective database of 141 patients who underwent surgery for TMNG disease from January 1985 to December 2008. During that period, six patients underwent subtotal thyroidectomy and 135 patients underwent near total thyroidectomy. Around 53 patients (38%) underwent surgery for recurrent disease after medical therapy; 88 patients (62%) had surgery as a primary treatment, the indications were large goiter size in 58 (66%), associated cold nodule in 16 (18%), patient preference in 14 (16%). The incidence of cancer was 6.4%. Permanent hypoparathyroidism was observed in two patients. Unilateral transitory vocal cord palsy was observed in 11 patients (8%), no bilateral transitory vocal cord palsy was observed. One unilateral definitive vocal cord palsy was observed and was provoked by a mediastinal compression. Two patients (1.5%) experienced postoperative hemorrhagia requiring surgical revision. Near total thyroidectomy for TMNG provide an immediate and definitive treatment with a low complication rate. Near total thyroidectomy offers an appropriate treatment for coexisting malignancy. Only NTT can alleviate compressive symptoms. This procedure can be safely recommended even as a primary treatment.

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