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PubMed2006

Submandibular ectopic thyroid gland.

Ectopic thyroid glands are generally a rare entity appearing mostly in the cervical midline (90% of the cases) and even more rarely in other anatomical sites (10%). We present the case of an ectopic submandibular thyroid gland. An 81-year-old woman was referred to our department with a history of right-sided submandibular swelling. Preoperative FNA revealed benign ectopic thyroid tissue. The patient was submitted to resection of the mass. Histological examination of the specimen confirmed the diagnosis. A substitution treatment with thyroxin was initiated postoperatively, as this was the only functional thyroid tissue. Review of the literature revealed 18 similar cases. Physicians should be aware of the possibility that a submandibular swelling could be an ectopic thyroid gland. This entity poses specific diagnostic and therapeutic difficulties. Thorough preoperative diagnostics and resection of the ectopic tissue guarantee a good outcome.

Aged, 80 and over↗

PubMed2002

Quality of life after gastrectomy: Longmire's reconstruction alone compared with additional pouch reconstruction.

The optimal reconstruction protocol after total gastrectomy is still a matter of debate. Pouch reconstructions are developed to create a larger reservoir for food, to provide a barrier against intestinoesophageal reflux, and to lengthen the food transit time. Preservation of the duodenal passage should result in better physiologic regulation of the ingested food. Controlled randomized clinical studies must be conducted to assess the quality of life after gastrectomy and various types of reconstruction. In the present trial, which compared Longmire's reconstruction without a pouch and Longmire's reconstruction with a pouch of varying sizes, we evaluated the quality of life for 41 patients during the first postoperative year. The quality of life was examined by an EORTC questionnaire and an organ-specific module. There were no statistically proven benefits for pouch reconstruction in comparison with Longmire's reconstruction alone. Some benefits are shown for the large pouch but it was only a trend. This is especially so with regard to diarrhea and food consumption. A definitive answer to the question about the value of a pouch reconstruction after gastrectomy has not yet been attained. It is possible that there will be significant differences between reconstruction groups during the long-term follow-up.

Adult↗