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PubMedDate not supplied

Total thyroidectomy or lobectomy in benign nodular disease of the thyroid: changing trends in surgery.

METHODS: Over a 23-month period (January 1994-December 1995) in the era of fine needle aspiration (FNA), 344 thyroid surgery operations were performed for benign diseases of the thyroid. Of these 55 total thyroidectomies or lobectomies were evaluated. Mean age was 43.6 + 9.7 and the female/male ratio was 47/8 (5.8). All cases were operated on with the consensus of the surgery + endocrinology + pathology council according to a protocol based on FNA, thyroid function tests, scintigraphy and ultrasound. Suspected FNA or suspected nodules during the surgery were verified by frozen section also. Of these 55 benign nodules, 7 (12.7%) had total bilateral, 48 (87.3%) unilateral lobectomies. RESULTS: Postoperatively 3 cases (5.8%) of seroma, one transient hypoparathyroidism (1.8%) and one unilateral vocal cord paralysis (1.8%) were seen as complications. CONCLUSIONS: In our center, FNA cytology has been a routine procedure since 1992. Surgery for benign thyroid disease has been reduced 50% since than. This study was started after two years of the FNA procedure. Resident nodules are the most common cause of recurrence in nodular thyroid disease, so some cases need radical surgery when it is decided to operate. Morbidity of surgery for recurrent disease is unacceptably high and is comparable to lifelong supplement therapy.

Adult↗
PubMed1997

[Surgical treatment of Basedow's disease: total thyroidectomy].

The Authors report their experience in the treatment of Graves disease. After a short review of the literature, the Authors stress the medical trait of such disease with possible spontaneous resolution. Therefore the number of cases surgically treated is necessarily low. Thirty patients, all with specific antibodies, were treated with total thyroidectomy. The therapy chosen and the results obtained are herein shown. No definitive hypoparathyroidism and inferior laryngeal nerve injuries were registered.

Graves Disease↗
PubMed1997

Thyroidectomy with and without drains.

Drainage after thyroid surgery has been widely used to prevent life-threatening complications. However, it is well known that drains do not always prevent haematoma formation. In this retrospective study, we reviewed our experience with 1057 thyroidectomies with and without drains in order to assess this issue. Between 1983 and 1993, 520 patients were closed with drains and 537 patients without drains after thyroid surgery. The indications for drainage of the selective period included wet operative field and large areas of dead space at the conclusion of the operation. Reoperation for bleeding was done in twelve patients in the drainage group and two patients in the non-drainage group (p < 0.05). Wound infection was seen in seven patients in the drainage group and none in the no-drainage group (p < 0.05). This study suggests that routine drainage after thyroid surgery is not necessary and a selective policy can be applied safely.

Adolescent↗
PubMedDate not supplied

DNA synthesis in isolated mitochondria: effect of thyroidectomy and of triiodothyronine administration in vivo.

The incorporation was studied of labelled deoxy-ribonucleosides triphosphates into acid-insoluble material by isolated liver mitochondria, obtained from either normal young male rats, or thyroidectomized at weaning, or thyroidectomized and then treated with triiodothyronine (T3). The incorporation extents in normal animals decreased with the age starting from the weaning until the 210th day. Thyroidectomy reduced the incorporation extent to about 70% of the values observed in normal animals. During the T3 treatment of thyroidectomized rats a sharp increase of incorporation was observed one day after the first administration, followed by a decrease from the 1st to the 3rd day; successively the incorporation extent remained unchanged until the 12th day. Finally, evidence was provided that T3 doses used were thyreomimetic and definitely lower than the thyreotoxic ones.

Aging↗
PubMed1998

Laryngeal nerve monitoring during thyroidectomy.

Electromyographic monitoring of vocal cord function during thyroidectomy is a very useful technique. It is non-invasive and provides valuable intraoperative data regarding the function of the recurrent laryngeal nerve.

Adult↗
PubMed1998

Local/regional anesthesia for thyroidectomy: evaluation as an outpatient procedure.

BACKGROUND: The purpose of this paper was to review my evolving experience with local/regional anesthesia in an outpatient setting. METHODS: Two hundred three consecutive patients during a 9-year period who chose to undergo thyroid operation under regional/local anesthesia were reviewed. Early discharge was offered to patients who were observed for 6 hours without neck swelling and who had no surgical reasons for delaying discharge. RESULTS: In group A there were 2 patients who were given inhalation anesthesia during operation compared with none in groups B and C. The average length of stay in group A was 0.49 days, 0.55 days in group B, and 0.24 days in group C. Eighty-five percent of the patients whose operation began before 1300 hours were discharged within 6 hours versus only 50% of those operated on later in the day. Forty-seven percent of patients in group A, 65% of group B, and 77% of patients in group C were discharged within 6 hours of operation. On the basis of previous experience with general anesthesia, discharge time is not significantly influenced by the type of anesthesia chosen. There were no readmissions to the hospital, but 2 episodes of postoperative bleeding required reoperation. Survey showed that 95% of patients rated the level of pain equivalent or less severe than dental procedures under local anesthesia, and all patients would choose local again. CONCLUSIONS: These data suggest that thyroidectomy can be performed with the patient under local/regional anesthesia, with low morbidity and high patient satisfaction. Most patients can be discharged within 6 to 8 hours, and these discharges were not associated with readmissions.

Adult↗
PubMed1978

[Electron microscope observation of "thyroidectomy cells" in the hypophyseal ventral lobe of a Chondrichthyan fish, the small spotted dogfish, Scyllium canicula Cuv].

In the adenohypophysis of very young spotted dogfish, only one kind of granulated cells show strcutural changes following thyroidectomy: the small granule cells of the ventral lobe (granule diameter about 110 nm). These cells are similar to the thyrotrophs of other Vertebrates, and well distinct from the supposed gonadotrophs found in the same lobe.

Animals↗
PubMed1975

Effect of partial thyroidectomy, propylthiouracil or thyroxine on estrogen-induced intranuclear inclusions in mammotrophs of the Mongolian gerbil.

Partial thyroidectomy caused a significant increase in the number of intranuclear inclusions per field (2-83 +/- 0-10 inclusions as compared with 0-15 +/- 0-03 inclusions for sham-controls). The inclusions occurred exclusively within mammotrophs. Thyrotrophs were stimulated: an increased cell size, numerous secretory granules, an enlarged Golgi apparatus and hypertrophic rough endoplasmic reticulum. Propylthiouracil caused similar ultrastructural changes although sighificantly fewer inclusions were observed (0-64 +/- 0-06 inclusions). Suppression of thyroid function with thyroxine produced no change in the number of inclusions (0-17 +/- 0-03 inclusions) although when combined with estrogen there were significantly fewer inclusions (1-62 +/- 0-07) when compared to estrogen alone (2-69 +/- 0-09). Intranuclear inclusions appear to be a unique reaction of mammotrophs to cellular hyperfunction in the Mongolian gerbil.

Animals↗
PubMed2005

Controversial ectopic thyroid: a case report of thyroid tissue in the axilla and benign total thyroidectomy.

A 43-year-old woman presented with a mass in her left axilla, which was surgically excised. Histologically, the tissue was a reactive lymph node with adjacent thyroid follicular tissue. The differential diagnosis included benign ectopic thyroid versus metastatic well-differentiated follicular-derived thyroid carcinoma. Because of the possibility of carcinoma, the patient underwent a diagnostic total thyroidectomy. The thyroid was grossly normal with no histologic evidence of malignancy. Post-operatively, the patient underwent a whole body 131I scan. Aside from an expected residual uptake in the thyroid bed region, there was no extrathyroidal uptake to suggest additional ectopic thyroid tissue or metastatic disease. At the time of this scan, her thyrotropin (TSH) was 92.8 microU/mL, thyroglobulin was less than 0.3 ng/mL, and thyroglobulin antibody was less than 3 IU/mL. Abnormalities in the embryologic development and migration of the thyroid gland can result in ectopic thyroid tissue. The most frequent locations are along the midline from the base of the tongue to the mediastinum. Only rare case reports exist of ectopic thyroid in other locations, including the chest (heart, trachea), abdomen (liver, gallbladder, pancreas), and pelvis (vagina). This case represents the first description of thyroid tissue in the axilla with a histologically benign thyroid gland.

Adult↗
PubMed1989

Morphometric investigations of the pineal gland after ganglionectomy and thyroidectomy under the aspect of circadian and seasonal variations.

It is well established that the pineal gland is involved in the regulation of thyrotropin (TSH) secretion. Previous investigations in our laboratory showed that under hypothyroid conditions the nuclear size of pinealocytes was diminished while an increase in the size of nuclei was seen under hyperthyroid conditions. In the present study we confirmed these results while considering circadian and circannual oscillations. After ganglionectomy (GX, removal of the sympathetic superior cervical ganglia) the mean annual values of the nuclear size of pinealocytes, pineal weights and thyroxine (T4) levels were diminished, whereas the pituitary weights increased. Comparable, but more drastical reactions were found after thyroidectomy (TX). The diminution of the nuclear size of pinealocytes was more pronounced in the wintertime (December, L: D = 8: 16), the finding for the summertime (June, L: D = 16: 8) being similar. Under short-day conditions the nuclear size was larger than under long-day regimes. In the winter the enhancement of the nuclear size was accompanied by decreased pituitary weights and increased T4 levels while under long-day conditions lower size of pinealocytes and T4 levels were associated with higher weights of pituitary glands. The statistically significant circadian patterns of the nuclear size of pinealocytes showed that the largest nuclei occurred at the end of the light phase or at the onset of the dark phase. In June, the largest nuclei were found in the middle of dark (control) or in the early light phase (ganglionectomy). Considering the circadian patterns of pineal weights and T4 levels, these results underline the existence of a functional connection between the pineal gland and the thyroid axis.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

[Effects of thyroidectomy and submaxillary sialoadenectomy on physiological parameters in the female rat].

The effects of interaction of the thyroid function with the submaxillary glands on the female rat, on the body growth, weight evolution of adrenal glands, ovary and parotid glands, puberty onset, estrous cycle, fertility, gestation and offspring size, plasmatic levels of glucose, glucagon, Na+, K+ and total protein have been studied. The effects of sialadenectomy and thyroid function are both independent in all parameters, except in ovary growth, which is depressed by thyroid function when submaxillary glands are removed, and in circulating glucose, since sialadenectomy stabilizes to hypoglycemia which results from thyroidectomy.

Animals↗