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 […]
Category: Endocrine Surgery
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 […]
Autofluorescence in Thyroidectomy Cuts Hypoparathyroidism Rates
Autofluorescence-guided total thyroidectomy significantly reduced immediate and permanent hypoparathyroidism rates in low-volume, nonparathyroid institutions. Introduction of autofluorescence decreased immediate hypoparathyroidism from 37% to 19% and permanent hypoparathyroidism from 32% to 6%, eventually reaching 0%. More parathyroid glands were identified and fewer inadvertently excised with autofluorescence. These findings suggest that the use of autofluorescence in thyroid […]
Thermal Ablation Matches Lobectomy in Long-Term Outcomes for Thyroid Microcarcinoma
Long-term multicenter study comparing image-guided thermal ablation to lobectomy for solitary papillary thyroid microcarcinoma showed no significant differences in disease progression or survival outcomes. Ablation had lower complication rates, shorter hospitalization, procedure time, reduced blood loss, and lower costs compared to lobectomy. Thermal ablation could be a safe and effective alternative for properly selected patients […]
