A comparative analysis of single-port techniques for adrenalectomies revealed that single-port single-channel laparoscopic surgery offers significant benefits for tumors up to 4 cm, including reduced hospital stay and pain. For tumors exceeding 4 cm, single-port multi-channel approaches facilitate shorter hospital stays and fewer additional punctures. All 218 adrenalectomies were successfully performed without conversion to open […]
Category: Endocrine Surgery
Sutureless harmonic scalpel reduces complications in thyroidectomy
A meta-analysis of 43 randomized controlled trials involving 10,361 patients reveals that the sutureless focus harmonic scalpel significantly lowers the risk of complications during thyroidectomy. The transient recurrent laryngeal nerve injury was reduced to 3.99% with the scalpel compared to 5.23% with the clamp-and-tie technique. Additionally, transient hypocalcemia rates were lower (11.3% vs. 15.4%). These […]
Key Risk Factors Identified for Surgical Site Infection in Thyroid Surgery
A systematic review and meta-analysis of 127,467 patients following thyroid surgery revealed critical risk factors for surgical site infections (SSI). Key contributors included surgical duration over two hours, existing comorbidities, patients older than 50 years, incision length greater than five centimeters, and lymph node dissection. Notably, while males had a significant association with SSI risk, […]
NIRAF imaging significantly enhances parathyroid gland identification
Near-infrared autofluorescence (NIRAF) imaging significantly improves the ability of surgical trainees to recognize parathyroid glands during thyroidectomy and parathyroidectomy. Detection rates soared for junior trainees from 46.5% to 94.8% and for senior trainees from 68% to 97%. Additionally, NIRAF identified 48.3% more glands for juniors, 29% for seniors, and increased confidence in recognizing known glands […]
Parathyroid hormone-based algorithm significantly reduces hypocalcemia after surgery
An algorithm utilizing intraoperative parathyroid hormone levels predicted symptomatic hypocalcemia in 90% of patients post-total thyroidectomy. Implementing routine calcium supplementation led to a drop in symptomatic hypocalcemia from 16% to 2.3% and a decrease in readmissions for related complications from 2.7% to 0.01%. While permanent hypoparathyroidism rates remained stable, the study demonstrated the algorithm’s effectiveness […]
Single-incision gasless trans-subclavian approach enables scarless thyroid surgery
A novel single-incision gasless trans-subclavian endoscopic approach for thyroidectomy has demonstrated feasibility in 243 patients. No conversions to open surgery occurred, with average surgery times of 84.9 minutes for lobectomy plus central neck dissection and 95 minutes for lobectomy alone. Complications included temporary recurrent laryngeal nerve injury in eight cases and one minor lymphatic fistula. […]
ICG imaging effectively predicts benign adrenal tumors intraoperatively
Near-infrared indocyanine green (ICG) imaging demonstrates promise in distinguishing between benign and malignant adrenal tumors during robotic surgeries. In a cohort of 197 patients, the method achieved an 87% sensitivity and a positive predictive value of 95.2% for identifying benign tumors. While specificity and negative predictive value were lower, results indicate that ICG can significantly […]
Levothyroxine treatment reduces goiter recurrence after thyroid surgery
A 20-year follow-up of patients who underwent unilateral thyroid lobectomy revealed that those receiving postoperative levothyroxine treatment experienced a significantly lower recurrence of nodular goiter compared to those who did not, with rates of 3.3% versus 30.0%, respectively. Additionally, 4.9% of the levothyroxine group required further surgery, contrasting with 30.0% in the untreated group. Notably, […]
De-escalating preoperative α-blockade improves outcomes for pheochromocytoma surgery
Implementing a de-escalated preoperative α-blockade protocol for pheochromocytoma adrenalectomy shows promising results. The study involving 82 patients indicated that this approach led to a significantly shorter hospital stay (2.5 days compared to 7.1 days) and reduced duration of postoperative norepinephrine use (0.3 hours versus 5.1 hours). Although symptomatic hypotension was more common in the de-escalated […]
Quality improvement indicators for thyroid cancer surgeries identified
A multidisciplinary team highlighted critical surgical quality indicators for thyroid cancer, assessing care across 51 hospitals and involving 112 surgeons. Findings revealed that 34.3% of thyroid cancer cases lacked preoperative cytology, and significant gaps in adherence to follow-up protocols were observed, with 19.2% of patients missing documented follow-up. The initiative underscores the necessity of a […]
