Humans ; Thyroid Diseases ; diagnosis ; surgery

From July 1999 to July 2000, in Military Hospital 103 there have been 459 patients with thyroid diseases undergoing surgical treatment. The rate of postoperative respiratory insufficiency was 2.6% (1.4% of 288 patients with Basedow's disease; 3.6% of 28 patients with simple goiter, 1.6% of 128 patients with benign tumor of the thyroid; 33.3% of 15 patients with thyroid cancer). Some factors related to respiratory insufficiency after surgical treatment of thyroid diseases are the type of thyroid disease, mixed goiter, big goiter, goiter with symptoms of pressing on neck's organs and recidivous goiter.
Thyroid diseases ; Respiratory Insufficiency ; diagnosis ; surgery ; therapeutics

OBJECTIVETo study on thyroid bilateral gland lobe disease with endoscopic monolateral anterior chest approach.

METHODSTwenty patients experienced thyroid bilateral gland lobe surgery with endoscopic monolateral anterior chest approach; 24 experienced conventional surgery simultaneously and were enrolled in control group. Two groups were compared at surgical style, complications, surgical time, length of stay in hospital, incision cosmetic result and incision pain etc. Criteria of patients selected for thyroid bilateral gland lobe surgery with endoscopic monolateralanterior chest approach:with no surgical history of thyroid or other neck-related diseases and no chemotherapy; diagnosed with benign tumor according to presurgery CT result and thyroid functional examination. Diameter of tumor on both sides should be smaller than 4 cm, one side smaller than 2 cm, located at lower middle part of gland lobe and near to gland surface.

RESULTSPatients in both groups matched in age and sex; scorings on surgical style, hospital stay, postoperative drainage, and postoperative pain were not significantly distinctive. Endoscopic group had less bleeding volumn than conventional group during surgery, better cosmetic results, but longer surgical duration and higher cost of hospitalization. Both groups occurred no permanent glottic paralysis and hypocalcemia, no recurrence. Endoscopic group had one case ecchymoma; one case temporary glottic paralysis; both recovered in one month. Complication incidence in both groups was not significantly distinctive (chi(2) = 2.514, P = 0.201).

CONCLUSIONSGasless endoscopic monolateral anterior chest approach can well treat selected thyroid bilateral gland lobe disease and with a better cosmetic result than conventional surgery.

Humans ; Neoplasm Recurrence, Local ; surgery ; Thyroid Diseases ; surgery ; Thyroid Neoplasms ; surgery ; Thyroidectomy

Objective: To describe the demographic and clinical characteristics of patients diagnosed with intrathoracic thyroid masses managed surgically in our institution, determine associated factors affecting eventual operative approaches for these patients, and assess postoperative outcomes and complications associated with surgical intervention. Methods: Design: Retrospective descriptive case series. Setting:Tertiary National University Hospital. Participants: 24 patients. Results: The mean age of patients diagnosed with intrathoracic goiters was 55.71 years old, with a 1:1.4 male to female ratio; with most having an intrathoracic extent of Huins Grade 1 (67%) compared to others having Huins Grade 2-3. Majority of patients pre-operatively had a Fine Needle Aspiration (FNA) Bethesda Thyroid Nodule Classification of Category II (benign); 79% of total patients underwent excision of thyroid mass utilizing a transcervical approach alone. As Intrathoracic Extension (ITE) grade increased, additional transthoracic approaches were performed; duration of operation, average estimated blood loss, length of hospital stay was also noted to increase. Majority of post operative surgical histopathology results revealed malignant thyroid masses, in contrast to pre-operative FNA. Post-operative transient hypocalcemia was the most reported immediate complication. Conclusions Management of intrathoracic goiter is often multidisciplinary. Referral to the thoracic vascular service is warranted for access to the thoracic inlet. Classification by grade of intrathoracic goiters is helpful to determine the most appropriate operative approach and may be predictive of intraoperative and postoperative outcomes. Postoperative histopathology across all ITE grades mostly yield malignant results; hence, preoperative FNA results should be used with caution.
Thyroid Diseases ; Thyroid Neoplasms ; Goiter ; Thyroid Gland ; General Surgery ; Thyroidectomy ; Sternum ; Manubrium

OBJECTIVERobot-assisted endoscopic surgery has been increasingly accepted because of its unique three-dimensional vision and precise simulation-based technology. However, the utilization of robotic systems in thyroid surgery is limited. We conducted a systematic review to assess the application and development of robot-assisted endoscopic surgical technique in thyroid surgery.

DATA SOURCESArticles published in PubMed before June, 2011 about robot-assisted endoscopic surgery were selected.

STUDY SELECTIONOriginal articles and critical reviews selected were related to robot-assisted (thyroid) surgery or endoscopic thyroid surgery, and a total of 3540 relevant articles were retrieved and 34 were finally cited.

RESULTSRobot-assisted operation of benign thyroid diseases were successfully performed, although the operation time is too long to exhibit its advantages. Nevertheless, the superiority of robot-assisted endoscopic surgical technique compared to conventional endoscopic surgery in the treatment of thyroid carcinoma were obvious, since robotic radical thyroidectomy with central and lateral neck lymph node dissection could be achieved while maintaining operative results and cosmetic outcomes equivalent to or better than conventional endoscopic surgery. Furthermore, the learning curve duration of robot-assisted endoscopic thyroid surgery was shorter than that of conventional endoscopy, especially for the novices without any endoscopic surgical basis.

CONCLUSIONRobot-assisted endoscopic thyroid surgery, with its safety, feasibility, thoroughness, cosmetic benefits, and ability to overcome the limitations of conventional endoscopic surgery, will be further improved and applied, and is worthy of attention.

Endoscopy ; methods ; trends ; Humans ; Robotics ; methods ; trends ; Thyroid Diseases ; surgery ; Thyroid Gland ; surgery ; Treatment Outcome

Humans ; Pyriform Sinus/surgery* ; Thyroid Neoplasms/diagnosis* ; Fistula/surgery* ; Diagnostic Errors ; Pharyngeal Diseases/surgery*

Although several findings of historical writings have been made, the exact role of the thyroid was not known in the ancient times. From the middle of the nineteenth century, the anatomy and the physiological role of the thyroid were gradually elucidated, and diagnostic and therapeutic modalities were developed. It has been 100 years since Theodor Kocher was awarded the Nobel Prize for his work in pathophysiology and surgery of the thyroid. Fifty years have passed since radioactive iodine was first used for the diagnosis and the treatment of hyperthyroidism in Korea. Today, thyroid cancer is one of the most prevalent malignancy in Korean women. However, the detailed history of the thyroid disease has not been introduced in Korea. The aim of this paper is to describe the historical perspectives of the thyroid disease, especially focusing on the development of the treatment. The common thyroid disease ere named after their discoverers, such as Graves and Hashimoto. It is meaningful to understand the historical background of the thyroid gland, because the important concepts in the area of endocrinology such as hormone replacement therapy, feedback mechanisms, and the use of isotopes were first established based on the research of the thyroid.
Female ; History, 19th Century ; History, 20th Century ; Humans ; Thyroid Diseases/*history ; *Thyroid Gland/physiopathology/surgery ; Thyroid Neoplasms/history

OBJECTIVETo probe into peripheral nervous mechanisms of analgesic effect of electroacupuncture (EA) at Hegu (LI 4) and Neiguan (PC 6) on cervical region.

METHODSTwenty cases of thyroid disease who wished to receive acupuncture anesthesia, were stimulated with electroacupuncture at bilateral Hegu (LI 4), Neiguan (PC 6) in continued wave, intensity of 6-8 V, frequency of 10-20 Hz. After stimulation for 40 min, the operation was made. Before EA stimulation, 10 min, 20 min and 30 min after EA stimulation, changes of the physiologi cal functions including latent period, conduction velocity, wave peak amplitude of great auricular nerve were monitored and changes of pain sense were detected.

RESULTSAfter EA given at Hegu (LI 4) and Neiguan (PC 6) for 10 min, 20 min and 30 min, the pain sense significantly decreased (P<0.01), the latent period of great auricular nerve was shortened, and the conduction velocity was fastened and the wave peak amplitude raised with significant changes as compared with those before EA stimulation (P<0.01).

CONCLUSIONEA at Hegu (LI 4) and Neiguan (PC 6) can produce a better analgesic effect on cervical region; EA at Hegu (LI 4) and Neiguan (PC 6) induces electro-physio logic changes of the nerve innervating the cervical region, showing increase of excitability; the nerves innervating Hegu (LI 4) and Neiguan (PC 6) and the nerves of cervical region possibly are homologous nerves.

Acupuncture Analgesia ; Acupuncture Points ; Adult ; Electroacupuncture ; Humans ; Male ; Middle Aged ; Pain Management ; Pain Measurement ; Thyroid Diseases ; surgery ; Thyroid Gland ; surgery

Adult ; Female ; Humans ; Laryngeal Diseases ; surgery ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Thyroid Cartilage ; surgery

OBJECTIVETo study the changes in the constituent ratio of patients received surgical therapy for their thyroid diseases in Peking Union Medical College Hospital from 1986 to 2012.

METHODSThe clinical data of patients received surgical therapy with pathologically confirmed findings from 1986 to 2012 were collected, and a corresponding database was established. The constituent ratios of thyroid diseases and thyroid malignant tumor among different population groups in different years were analyzed.

RESULTSThe number of patients with thyroid diseases admitted to our hospital had significantly increased in the past 27 years, particularly those with nodular goiter or thyroid cancer. The composition ratios of thyroid cancer and nodular goiter increased significantly, and among malignancies the papillary thyroid carcinoma increased obviously. The detection rate of papillary thyroid micro-carcinoma had continuously increased since 2008.

CONCLUSIONThyroid diseases and malignant tumor pathological types had dramatically changed in hospitalized patients in our hospital in the past 27 years.

Adult ; Female ; Goiter, Nodular ; epidemiology ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Diseases ; epidemiology ; surgery ; Thyroid Neoplasms ; epidemiology ; pathology