Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “THYROIDECTOMY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 379 records · Page 21Linked to original sources
PubMed1979

Feasibility of total thyroidectomy in the treatment of thyroid carcinoma: postoperative radioactive iodine evaluation of 140 cases.

The objective of this study was to evaluate our experience with so-called total thyroidectomy. Fifty cases (the retrospective group) had been operated on before the start of the study and had been on thyroid replacement therapy; this was discontinued, thyroid-stimulating hormone was administered, and iodine-131 studies were performed. Ninety cases (the prospective group) were evaluated 3 or more weeks postoperatively with no thyroid hormone having been administered. All patients were given 50 microcuries of iodine-131 and uptake studies were performed 24 hours later. All the patients were evaluated at a time when it was believed that practically all circulating hormone secreted by the thyroid gland before its removal had been metabolized or excreted from the body. If the patients with iodine-131 uptakes only in the region of the pyramidal lobe are considered to have had total thyroidectomy, we find that 85.7% of the patients studied had an uptake of less than 1.5%, and 96.4% had an uptake of less than 2.5%. There is increasing evidence to indicate that total thyroidectomy is the procedure of choice in the treatment of differentiated thyroid carcinoma. The present study indicates that with proper technique, total resection of the thyroid gland is feasible in nearly all cases of thyroid carcinoma.

Adolescent↗
PubMed1981

Parathyroid autotransplantation in patients with parathyroid disease and total thyroidectomy. Indications in 117 cases.

Parathyroid autotransplantation is a known and increasingly utilized procedure. It is indicated in patients with primary parathyroid hyperplasia, in patients with primary hypercalcemia who have normal parathyroid tissue devascularized during surgery, in patients with secondary and tertiary parathyroid hyperplasia, and in patients with total thyroidectomy when normal parathyroid tissue is accidentally or unavoidably removed or completely devascularized. No normal viable parathyroid tissue should be autotransplanted. This procedure was performed in 13 dialysis patients, 27 primary hypercalcemic patients and 77 patients with thyroidectomy. The hypercalcemic patients had autotransplantations into muscle pockets in the volar surface of the forearm, while the thyroidectomy patients had autotransplantation into the sternocleidomastoid muscles. The application of parathyroid autotransplantation is a major technical and physiologic breakthrough in the field of thyroid and parathyroid surgery. It should greatly reduce the morbidity associated with permanent hypocalcemia in this type of extensive surgery.

Adult↗
PubMed1989

A descriptive experience of total thyroidectomy as the initial operation for differentiated carcinoma of the thyroid.

Sixty-five patients with differentiated carcinoma of the thyroid gland were registered with the tumor registry of Camp Lejeune Naval Hospital. There were no death attributed to thyroid carcinoma. A vigorous follow-up program was followed, and 11 recurrences were diagnosed and treated. Recurrences were considered treatment failures. The recurrence rate for total thyroidectomy patients was much lower than for any other operation. Many investigators, including those of two current surgery textbooks, have acknowledged that total thyroidectomy is superior for control of the disease but have been reluctant to recommend it because the complications are presumed to be too numerous. The results of this analysis rebut that presumption. The operating surgeons are not thyroid experts, yet their results were excellent. It is reasonable to assume that a trained general surgeon is capable of performing a total thyroidectomy without an unacceptable high incidence of postoperative complications.

Adenocarcinoma↗
PubMed1986

Effects of castration and thyroidectomy on the annual biological cycles of the edible dormouse Glis glis.

The annual cycle of hibernation, body weight, and plasma testosterone and thyroxine levels were compared in 7 orchidectomized and 16 intact dormice under natural conditions, and in 21 thyroidectomized and 23 intact dormice exposed to a 12-hr light and 12-hr darkness photoperiod under natural temperatures. Hibernation was not affected by either orchidectomy or thyroidectomy, nor did thyroidectomy alter the annual body weight cycle, which, however, was obliterated by orchidectomy. As regards endocrine cycles, orchidectomy had no significant effects on the annual thyroxine cycle, whereas thyroidectomy obliterated the annual testosterone cycle, which was replaced by short-lived, infradian plasma thyroxine cycles. As the latter resembled the fluctuations previously observed in intact animals exposed to constant ambient temperatures, it is proposed that in edible dormice, the annual thyroid cycle, which is thermoperiodically entrained, in turn entrains the testosterone cycle.

Animals↗
PubMed1986

Results of early thyroidectomy for medullary thyroid carcinoma in children with multiple endocrine neoplasia type 2.

Children with multiple endocrine neoplasia type 2 (MEN2) often develop medullary carcinoma of the thyroid (MCT) or its precursor, C-cell hyperplasia. Survival results are improved if malignancy is diagnosed early from the results of plasma immunoreactive calcitonin (iCT) measurement. The effect of early detection and thyroidectomy in children with MEN2 syndrome was determined by reviewing the experience between 1975 and 1985. Seventeen children with MEN2 who were 12 years old or younger underwent a total thyroidectomy for MCT or C-cell hyperplasia. iCT was measured in all patients preoperatively and postoperatively. Of the 17 children, 14 (82%) had MEN2a and 3 (18%) had MEN2b. There were 14 (82%) female and three (18%) male patients; their mean age was 6.97 years (range 1.5 to 12 years). In all patients, the diagnosis of MCT was made from initial elevated levels of iCT after stimulation with pentagastrin. Three patients had clinical evidence of disease preoperatively. All patients underwent a total thyroidectomy and lymph nodes were removed from the central zone; a neck dissection was performed in the three with clinically obvious disease. MCT with C-cell hyperplasia was found in 11 children and C-cell hyperplasia alone in six. Of the 11 with carcinoma, eight had bilateral disease and three unilateral. Six children had bilateral C-cell hyperplasia. All 17 children were alive and feeling well at the time of this report; however, three had evidence of metastatic disease according to iCT measurements. None of the children had recurrent nerve injuries; one had evidence of hypoparathyroidism.(ABSTRACT TRUNCATED AT 250 WORDS)

Calcitonin↗
PubMed1990

Evaluation of children with multiple endocrine neoplasia type IIb following thyroidectomy.

Medullary thyroid carcinoma (MTC) develops in all patients with multiple endocrine neoplasia type IIb (MEN IIb), a rare syndrome that either occurs sporadically or is inherited in an autosomal dominant pattern. The MTC in patients with MEN IIb has been reported to be biologically aggressive with onset at a young age and rapid progression as evidenced by widespread metastases and death, frequently in the teenage years. Seven children, aged 2 to 11 years (mean, 7 years), from three kindreds with MEN IIb were evaluated for evidence of tumor recurrence 3 to 10 years following thyroidectomy. In one child, age 11, a thyroid mass was palpable preoperatively. However, in the remaining six children (aged 2 to 10 years), the diagnosis of MTC was established by an increased concentration of plasma calcitonin (CT), either basally or following pentagastrin (Pg) stimulation. All patients underwent total thyroidectomy with removal of central lymph nodes from the neck. At the time of surgery, six children were found to have bilateral macroscopic MTC, five without and one with cervical metastases. One child (age 2 years) had C-cell hyperplasia, a premalignant precursor of MTC. Currently, five of the seven children are without evidence of recurrent disease clinically and have normal plasma CT levels (less than 0.3 ng/mL) following calcium (Ca) and Pg stimulation 3, 3, 10, 10, and 10 years after thyroidectomy. Two of the seven children have biochemical evidence of residual MTC.(ABSTRACT TRUNCATED AT 250 WORDS)

Biomarkers, Tumor↗
PubMed1985

Alterations in circulating thyroid hormones and thyrotropin in euthyroid patients with Graves' disease after total thyroidectomy: comparison between responders and nonresponders to TSH-releasing hormone.

Eleven euthyroid patients with severe exophthalmos of Graves' disease who had been treated with antithyroidal drugs for one to three years prior to total thyroidectomy were studied. All patients were clinically and biochemically euthyroid at the time of operation. According to their responses of TSH to TRH prior to operation, the patients were divided into two groups: (1) five responders and (2) six nonresponders. In group 1, serum TSH levels increased significantly on the third day after thyroidectomy (from 1.5 +/- 0.3 to 8.6 +/- 1.4 microU/mL: P less than 0.05); serum T4 concentrations decreased significantly and were in the hypothyroid range by the third day. In group 2, serum TSH levels rose from 0.5 +/- 0.01 to 3.2 +/- 0.5 microU/ml (P less than 0.05) on the ninth postoperative day; serum T4 concentrations decreased on the third day after operation but did not attain hypothyroid levels until the 12th day. Thus after total thyroidectomy the following are concluded: (1) serum TSH levels even in treated euthyroid patients with Graves' disease, rose more gradually in TRH-nonresponders in comparison with TRH responders; (2) the time when serum TSH elevation occurs is dependent upon serum concentrations of thyroid hormones (serum T3 and T4).

Adult↗
PubMed1986

Influence of thyroidectomy on brain catecholamines during the postnatal period.

The influence of early thyroidectomy (Tx) on changes in dopamine (DA) and noradrenaline (NA) during the postnatal period (30, 45 and 60 days old) was studied in the diencephalon and the rest of the brain of male and female rats. Thyroidectomy interfered with the normal growth of the animals, decreased brain weight and markedly influenced the developmental pattern of both DA and NA in the diencephalon. When compared with control values, the DA concentration, in 45- and 60-day-old Tx male rats, was 29 and 43% lower, respectively, and 21 and 43% lower, respectively, in Tx females. Diencephalic NA levels in Tx rats were also lower than those observed in controls, 15% inferior in 45- and 60-day-old males; 27 and 22% lower, respectively, in females. Thyroidectomy does not significantly alter the level of either amine in the rest of the brain.

Animals↗
PubMed1993

Effect of thyroidectomy and adrenalectomy on changes in liver glutathione and malonaldehyde levels after acute ethanol injection.

At low concentrations ethanol is metabolized largely by alcohol dehydrogenase to acetaldehyde, while at higher concentrations a microsomal ethanol oxidising system (MEOS) is involved, namely cytochrome P450 IIE1, which also probably generates free radical species. In hyperthyroidism hepatic glutathione stores are depleted and net superoxide anion production occurs. In contrast, in hypothyroidism hepatic glutathione may be increased and thus renders the liver less sensitive to alcohol generated free radical production. Steroid hormones inhibit lipid peroxidation. Sixty male Wistar rats either underwent thyroidectomy, adrenalectomy, or sham procedures. Twenty control animals were pair fed with thyroidectomized animals, whilst another twenty fed ad libitum. An intraperitoneal injection of alcohol (75 mmol/kg) was given 2.5 h prior to sacrifice to half the animals in each group, the remainder receiving saline. The total hepatic glutathione contents of the pair fed and the ad libitum groups were not different, but were significantly increased by thyroidectomy (p = < 0.001). This effect was significantly reduced by alcohol (p < 0.01). The sham procedures and dietary restrictions had no effect. The ethanol alone reduced total hepatic glutathione, but this only reached statistical significance in the thyroidectomized and sham-adrenalectomized groups. Hepatic malonaldehyde (MDA) levels were significantly reduced in the thyroidectomy group but alcohol had no effect on them. We conclude that hypothyroidism increased hepatic glutathione status, presumably by reducing radical production by enzyme systems, which would otherwise consume this important scavenger. Long term exposure to ethanol with induction of MEOS is probably required for it to generate toxic levels of free radical species.

Adrenal Glands↗
PubMed2005

Total thyroidectomy for multinodular goiter in the elderly.

BACKGROUND: Total thyroidectomy for multinodular goiter (MNG) is increasingly being performed for the elderly population and yet their perioperative and long-term outcomes remain unclear. METHODS: A total of 279 patients who underwent total thyroidectomy for MNG in a university-based hospital during a 9-year period were analyzed according to their age at the time of operation. RESULTS: The duration of operation (P=.023), intraoperative blood loss (P=.030), weight of resected thyroid glands (P<.001) and proportion of retrosternal goiter (P<.001) were significantly greater in the elderly group (>/=70 years) (n = 55), but the incidence of surgically related complications, including recurrent laryngeal nerve palsy and hypoparathyroidism, was similar. Postoperative pneumonia occurred more frequently in the elderly group (P=.034). The number of comorbidities tended to correlate with the length of hospital stay and long-term survival in elderly patients. CONCLUSIONS: Total thyroidectomy for MNG in elderly patients had a similar perioperative outcome as their younger counterparts, but their long-term outcome is likely to be influenced by the number of comorbidities.

Adult↗
PubMed2006

Routine oral calcium and vitamin D supplements for prevention of hypocalcemia after total thyroidectomy.

BACKGROUND: The purpose of this study was to evaluate the clinical usefulness of routine oral calcium and vitamin D supplements in the prevention of hypocalcemia after total thyroidectomy. METHODS: Ninety patients who underwent total thyroidectomy were randomly assigned to routinely receive or not receive a supplement containing oral calcium (3 g/d) and vitamin D (1 g/d) for 2 weeks. Hypocalcemic signs and symptoms, serum calcium, and parathyroid hormone (PTH) levels were monitored and compared between the 2 groups. RESULTS: The incidences of symptomatic and laboratory hypocalcemia were significantly lower in the oral calcium/vitamin D group than in the group not receiving the supplement: 3 of 45 patients (7%) versus 11 of 45 (24%) and 6 of 45 (13%) versus 16 of 45 (36%), respectively (P < or = .02). The hypocalcemic symptoms were minimal in the supplement group but more severe in the group not receiving the supplement. Serum calcium levels decreased in both groups after surgery but recovered earlier in the supplement group. No hypercalcemia or PTH inhibition developed in the supplement group. CONCLUSION: Routine administration of a supplement containing oral calcium and vitamin D is effective in reducing the incidence and severity of hypocalcemia after total thyroidectomy.

Adolescent↗
PubMed2005

Presymptomatic thyroidectomy in multiple endocrine neoplasia 2a.

AIMS: To evaluate the value of prophylactic total thyroidectomy in multiple endocrine neoplasia 2a (MEN 2a), based on results of genetic testing, in a presymptomatic early stage of the disease. METHODS: Fourteen presymptomatic patients genetically diagnosed and surgically treated at our centre. We analysed age, gender, location of the RET mutation, calcitonin tests, surgery, histologic findings, TNM classification, and postoperative follow-up. RESULTS: The 14 patients belonged to two families with MTC (MEN 2a). Median age was 16 years. The RET mutation was located in codon 618 and 634. Basal calcitonin (CT) levels were normal in all patients. Twelve had pathologic peak CT measurements. Total thyroidectomy was performed in all and associated central neck dissection in 12 patients. Pathohistologic assessment showed C-cell hyperplasia in all specimens and 11 MTCs; the median size of the tumours was 0.2 cm; two patient had lymph-node metastases. According to TNM, three had stage 0, nine had stage I, one had stage II, and one had stage III disease. Postsurgery basal and peak CT values were normal in all but one patients, indicating a biochemical curative rate of 95%. Calcitonin determination did not distinguish between MTC and C-cell hyperplasia. CONCLUSION: Prophylactic thyroidectomy based on genetic testing allows identification and treatment of patients at an early stage of the disease. Pathologic peak CT values are markers for the presence of microscopic MTC and should be considered in selecting operative procedures for these patients.

Adolescent↗
PubMed2006

Extensive thyroidectomy in Graves' disease.

BACKGROUND: The best surgical treatment for hyperthyroidism caused by Graves' disease remains a controversial subject. METHODS: Seven hundred fourteen consecutive patients underwent total or near-total thyroidectomy for Graves' disease in a 13-year period. In a first analysis, postoperative rates of suffocating hematoma, wound infection, recurrent laryngeal nerve (RLN) palsy, hypoparathyroidism, and persistence or recurrence of hyperthyroidism, were studied and compared with the same parameters in 4,426 patients who underwent bilateral thyroid gland resection for other conditions. A second analysis identified factors associated with postoperative complications among Graves' disease patients. RESULTS: Comparing Graves' disease patients with patients who had bilateral thyroid resection for other conditions, the transient morbidity rate was 13.3% versus 8.2% (p < 0.0001), with 10.2% versus 5.0% (p < 0.0001) hypoparathyroidism, 2.2% versus 1.7% (p = 0.35) RLN palsy, 1.7% versus 0.9% (p < 0.05) suffocating hematoma, and 0.3% versus 0.4% (p = 0.67) wound infection, respectively. Permanent morbidity rate was 2% versus 2.2% (p = 0.72), including 0.4% versus 0.6% RLN palsy and 1.5% versus 1.7% hypoparathyroidism. Among the Graves' disease patients, univariate analysis revealed that those who experienced postoperative complications had a higher weight resected thyroid gland (odds ratio = 1.5; 95% CI, 1.0-2.3) and a higher rate of total thyroidectomy (24.4% versus 19.5%, odds ratio = 2.2; 95% CI, 1.4-3.4) than patients without complications. In the multivariable model, these two factors remained independent. There was no recurrence of hyperthyroidism with a median followup of 6.7 years (interquartile range 4.1 to 10.1 years). Persistent hyperthyroidism developed in three patients. CONCLUSIONS: Total or near-total thyroidectomy is an effective and safe treatment for Graves' disease when performed by an experienced surgeon.

Adult↗
PubMed2004

Minimally invasive video-assisted thyroidectomy: report of 16 cases in children older than 10 years.

METHODS: From October 1998 to December 2002 in the Department of Surgery at the University of Pisa, 16 patients ages 18 years or younger (14 girls, 87.5%, and 2 boys, 12.5%; range, 11 to 18; mean age, 15 years, 8 months) underwent a surgical operation with video-assisted technique for thyroid pathology. These patients belong to a larger group of 270 patients treated with this technique. Surgical therapy with video-assisted technique was chosen; a lobectomy was used in 15 cases (90.0%) and a total thyroidectomy in 1 case (10%). RESULTS: Two patients (12.5%) underwent a second video-assisted operation to complete the thyroidectomy for a false-negative result at extemporal histologic examination during the first operation. The histologic examination found benign pathology in 14 cases (87.5%) and a malignant lesion (papillary type) in 2 cases (12.5%). No postoperative complications were observed. CONCLUSIONS: The results of the mini-invasive video-assisted technique for thyroidectomy in this preliminary experience seem to be equal to those of the traditional open surgical technique (200 surgical operations for thyroid pathology for the ages 18 years or younger). Elective indications of the mini-invasive video-assisted technique are the volume of the nodule and hystological type; this technique cannot be used in cases of voluminous goiter, medullary carcinomas and poorly differentiated carcinomas. The advantage that this technique offers, in addition to a better postoperation period, is an improved esthetic result, which is particularly important in young patients.

Adenoma↗
PubMed2007

Prophylactic thyroidectomy in pediatric carriers of multiple endocrine neoplasia type 2A or familial medullary thyroid carcinoma: mutation in C620 is associated with Hirschsprung's disease.

PURPOSE: Prophylactic total thyroidectomy is now recommended after having confirmed RET mutations in children of parents with multiple endocrine neoplasia type 2 or familial medullary thyroid carcinoma. We reviewed our experience to determine the incidence of medullary thyroid carcinoma with respect to age at surgery, the location of the mutation, and its association with Hirschsprung's disease (HD). METHODS: A retrospective review from 1996 to 2005 revealed 20 children with genetic screening for multiple endocrine neoplasia type 2A or familial medullary thyroid carcinoma who underwent a prophylactic total thyroidectomy with parathyroid gland preservation. RESULTS: The median age of the 20 patients (9 boys and 11 girls) included in this study was 8.2 years (range, 3.7-16.9 years) at the time of their surgery. Final pathology revealed normal thyroid tissue (n = 3; median age, 5.9 years), C-cell hyperplasia (n = 13; median age, 10 years), or medullary thyroid carcinoma (n = 4; median age, 8 years). Four children, all with mutations in C620, had a previous diagnosis of HD. At a median follow-up of 3.7 years (range, 1 month to 8.4 years), all patients were well and cancer free. CONCLUSIONS: There is no correlation between histologic findings and median age at surgery. Hirschsprung's disease was found in 50% of the patients with the RET mutation in C620. In children of C620 parents, symptoms of HD should be actively sought, and if such are found, rectal biopsies should be performed even if mutation results are not yet available. Based on the age of the earliest cancer and the safety of total thyroidectomy, children should promptly undergo surgery after genetic screening and before their fifth year of life.

Adolescent↗
PubMed2006

Parathyroid hormone: a sensitive predictor of hypocalcemia following total thyroidectomy.

OBJECTIVE: To investigate whether monitoring parathyroid hormone (PTH) could predict hypocalcemia following total thyroidectomy or other bilateral thyroid manipulations. STUDY DESIGN AND SETTING: Forty patients undergoing total thyroidectomy as well as other bilateral thyroid procedures were prospectively enrolled. PTH levels were measured preoperatively and 30 minutes postoperatively. Calcium levels were measured preoperatively and every 8-12 hours for the first 72 postoperative hours. Changes in PTH levels as well as symptoms of hypocalcemia were correlated with postoperative hypocalcemia. RESULTS: Hypocalcemia developed in 13/40 patients (32.5%), mainly those patients undergoing total thyroidectomy in conjunction with paratracheal neck dissections. The respective sensitivity and specificity of a drop in PTH for detecting hypocalcemia was 92% and 66% (50% drop), 23% and 75% (75% drop), and 46% and 100% (drop below normal range). CONCLUSIONS: A 50% drop in PTH levels 30 minutes following bilateral thyroid procedures is a sensitive predictor of hypocalcemia. A drop of 75% is a highly specific indicator of postoperative hypocalcemia, though not highly sensitive. EBM RATING: C-4.

Adolescent↗
PubMed2006

Minimal incision for open thyroidectomy.

OBJECTIVES: To establish the incision length for thyroid surgery that optimizes access and cosmesis. STUDY DESIGN AND SETTING: Prospective study from January 2003 to June 2004. All thyroidectomies were included. Exclusion criteria were concomitant neck dissections, previous surgery, and those performed endoscopically. The first 40 cases were attempted through a 5 cm incision and the second 40 through a 4 cm incision. METHODS: In both groups, the size of the incision was compared with the thyroid's weight and histology. RESULTS: Two subtotal, 22 total, and 56 hemithyroidectomies were performed. In the first group, median gland weight was 39.5 gm and 62.5% of these were removed through a 5 cm incision. In the second group, median gland weight was 34 gm and 75% were removed through a 4 cm incision. CONCLUSION: A 4 cm incision provides adequate access for the majority of thyroidectomies in our cohort. SIGNIFICANCE: The minimal incision thyroidectomy is a useful addition to the thyroid surgeon's armamentarium. EBM RATING: B-3b.

Adult↗
PubMed2004

Minimally invasive, video-assisted thyroidectomy (MIVAT).

Minimally invasive, video-assisted thyroidectomy (MIVAT) was first used in Pisa in 1998. The technique is characterized by a unique central access and external retraction. There is controversy about the validity and limited indications of this and other minimally invasive thyroidectomy techniques, but MIVAT looks promising. The results of MIVAT, in 5 years experience, are similar to those of traditional thyroidectomy.

Female↗