A >50% decrease in intraoperative parathyroid hormone (iPTH) levels into the normal reference range predicts complete excision of malignancy in patients with parathyroid carcinoma. 93% of patients achieving normal iPTH levels had operative success, compared to only 50% of those with a >50% iPTH decrease alone. This study suggests that iPTH monitoring, particularly when guiding […]
Category: Endocrine Surgery
AI-Based Study Uncovers Tumor Heterogeneity in Papillary Thyroid Carcinoma
AI-based multimodal multi-tasks analysis of 1,011 PTC patients reveals molecular subtypes, impact of BRAF mutations on lymph node metastasis and prognosis. Deep learning model predicts metastasis with high accuracy (AUC 0.86-0.93) and generates heatmaps to aid clinicians in identifying high-risk areas. Offers valuable insights for precise risk stratification and personalized treatment decisions in PTC. • […]
Lobectomy is the preferred surgical choice for intermediate-risk papillary thyroid cancer
Lobectomy is superior to total thyroidectomy in reducing complications, including transient parathyroid dysfunction, for intermediate-risk papillary thyroid carcinoma patients. Both lobectomy and total thyroidectomy show similar effects on survival outcomes and recurrence rates. This systematic review and meta-analysis suggest considering lobectomy as the optimal surgical approach for intermediate-risk papillary thyroid cancer, as total thyroidectomy does […]
Indocyanine green angiography reduces hypoparathyroidism risk after thyroid cancer surgery
Indocyanine green angiography identified 14.75% of devascularized parathyroids during thyroid cancer surgery. Patients with all four parathyroids evaluated by angiography had decreased rates of permanent hypoparathyroidism compared to those without. In fact, no patients in the indocyanine group developed permanent hypoparathyroidism. This method may help to prevent long-term hypoparathyroidism in individuals undergoing thyroid cancer surgery, […]
Anatomical variations of the recurrent laryngeal nerve increase risk of vocal cord paralysis in thyroidectomy
Anatomical variations of the recurrent laryngeal nerve (RLN) during thyroidectomy, such as extralaryngeal branching and relation to the inferior thyroid artery (ITA), significantly increase the risk of vocal cord paralysis (VCP). This retrospective study on 1070 neck sides found that extralaryngeal branching nerves had higher VCP rates compared to nonbranching nerves. RLN crossing anteriorly or […]
High Efficacy and Low Complication Rate of Radiofrequency Ablation for Papillary Thyroid Microcarcinoma
Radiofrequency ablation (RFA) demonstrates a 99.81% volume reduction rate with minimal complications in treating low-risk papillary thyroid microcarcinomas. Over 46.59 months follow-up, only 69 patients experienced local recurrence, positioning RFA as a compelling alternative to surgery and active surveillance. Notably, retreatment rates were significantly lower post-RFA, highlighting its effectiveness as a long-term treatment option with […]
Thyroglobulin Wash-Out for Lymph Node Metastasis in Thyroid Carcinoma
Thyroglobulin wash-out after fine-needle aspiration cytodiagnosis effectively evaluates lymph node metastasis in papillary thyroid carcinoma. A cutoff value of 3.2 ng/ml for FNA-TG offers higher accuracy and lower false negatives than single diagnoses. Combining FNAC with FNA-TG increases sensitivity, though specificity decreases slightly. Ultrasonography provides dynamic LN assessment, enhancing diagnostic efficacy without added patient discomfort. […]
Ultrasound Predicts Lymphatic Spread in Papillary Thyroid Cancer
Ultrasound features like loss of fatty hilum, architectural distortion, enlarged size, and microcalcifications are associated with metastatic papillary thyroid cancer. A combination of these features shows high specificity and positive predictive value for malignancy. This study suggests a risk stratification model based on these ultrasound characteristics could improve the classification of nodal metastases in patients […]
Shift in Treatment Outcome Valuation for Low-Risk Thyroid Cancer
Patients with low-risk thyroid cancer changed their valuation of treatment outcomes after surgical decisions, favoring quality of life factors post-treatment. Emotional impact led to overuse of total thyroidectomy. Those choosing lobectomy increased importance on risk of recurrence, while total thyroidectomy patients valued it less. Surgeons can better discuss post-surgery effects on energy levels with patients […]
Reduced postoperative sore throat with combined budesonide and dexamethasone
Preoperative inhaled budesonide combined with intravenous dexamethasone significantly decreased postoperative sore throat (post) incidence and severity at 6, 12, and 24 hours in patients undergoing thyroidectomy. Additionally, this combination resulted in lower postoperative coughing rates at 24 hours compared to intravenous dexamethasone alone. Hoarseness outcomes were similar between the two groups. This combination therapy shows […]
