Humans ; Postoperative Complications/epidemiology* ; Postoperative Period ; Thyroid Neoplasms/surgery*

Objective:To investigate the relationship between parathyroid hormone（PTH） level and permanent hypoparathyroidism（PHPP） on the first day after radical papillary thyroidectomy, and its predictive value. Methods:A total of 80 patients with papillary thyroid cancer who underwent total thyroid resection and central lymph node dissection were collected and analyzed from January 2021 to January 2022. According to whether PHPP occurred after surgery, the patients were divided into hypoparathyroidism group and normal parathyroid function group, and univariate and binary logistics regression were used to analyze the correlation between PTH and serum calcium levels and PHPP on the first day after surgery in two groups. The dynamic changes of PTH at different time points after operation were analyzed. The area under the receiver operating characteristic was used to evaluate the predictive power of PTH on the development of PHPP after surgery. Results:Among the 80 patients with papillary thyroid cancer, 10 cases developed PHPP, with an incidence rate of 12.5%. Binary logistics regression analysis showed that PTH on the first postoperative day（OR=14.534, 95%CI: 2.377-88.858, P=0.004） was an independent predictive risk factor for postoperative PHPP. Taking PTH=8.75 ng/L on the first postoperative day as the cut-off value, the AUC of the area under the curve was 0.874（95%CI: 0.790-0.958, P<0.001）, the sensitivity was 71.4%, the specificity was 100%, and the Yoden index was 0.714. Conclusion:PTH level on the first day after total thyroid papillary carcinoma surgery is closely related to PHPP, and is an independent predictor of PHPP.
Humans ; Calcium ; Hypoparathyroidism/surgery* ; Parathyroid Glands ; Parathyroid Hormone ; Postoperative Complications/surgery* ; Thyroid Cancer, Papillary/surgery* ; Thyroid Neoplasms/complications* ; Thyroidectomy

OBJECTIVE: To investigate the clinical characteristics and surgical treatment of Hashimoto's disease complicated with thyroid cancer. METHODS: Clinical data of 54 patients with Hashimoto's disease complicated with thyroid cancer were retrospectively analyzed, including clinical characteristics, surgical treatment, and short-term effects. RESULTS: The rate of Hashimoto's disease complicated with thyroid cancer was 14.9%, 54 out of in 362 patients with Hashimoto's disease. All the 54 patients had surgical treatment in proper thyroid region, took euthyrox after the operation and had 6 month to 4 year followup. One patient had a local recurrence and 3 had lymph node metastasis in the neck, and these 4 patients had second operation on the thyroid gland. No death occurred. CONCLUSION Hashimoto's disease complicated with thyroid cancer has no typical symptoms.Combined examination of anti-thyroid antibodies test, color doppler imaging, CT detection, isotope scan and core/fine needle biopsy may provide accurate diagnosis. Proper surgical treatment is effective for Hashimoto's disease complicated with thyroid cancer.
Adult ; Aged ; Carcinoma, Papillary ; complications ; diagnosis ; surgery ; Female ; Hashimoto Disease ; complications ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Neoplasms ; complications ; diagnosis ; surgery ; Young Adult

Adult ; Female ; Horner Syndrome ; etiology ; Humans ; Neck Dissection ; Postoperative Complications ; Thyroid Neoplasms ; pathology ; surgery

OBJECTIVETo compare the total thyroidectomy or subtotal resection and gland lobe and isthmus lobectomy as initial treatment to TNM stage I and II differentiated thyroid cancer. The difference between recurrence rate and surgical complications were analysed.

METHODSThe literatures published between 1972-2012 were searched in Pubmed, Medline, Wanfang database, Chinese Biomedical Literature Database, Chinese scientific Journals database and China National Knowledge Infrastructure. According to the inclusion and deletion criteria, 17 articles were included to compare the postoperative recurrence and complications in randomized controlled or case-control studies, involving 13 articles in recurrence rate and 11 articles in complications.RevMan5.0 software package was used to perform meta-analysis.

RESULTSThirteen articles involved with the recurrence rate, the total case number was 3511. Among these cases, 414 recurred, overall recurrence rate was 11.59%, of which, 150 recurred cases in total or subtotal resection group (experimental group), the recurrence rate was 6.51%; 264 recurred cases in gland lobe lobectomy plus isthmus group (control group), the recurrence rate was 21.83%. Comparing the two groups, the odds ratio (OR) and their 95% confidence interval (95%CI) was 0.26 [0.21,0.33], Z value was 11.33, P < 0.01, which showed that the recurrence rate in experimental group was significantly lower than that in control group.Eleven articles involved with the complications, the total case number was 2388, 166 cases had postoperative complications. The complication rate was 6.95%, of which, 109 cases in experimental group, the complication rate was 8.52%; 57 cases in control group, the complication rate was 5.15%. Compared with the two groups, OR values and their 95%CI was 3.63 [2.47, 5.33], Z was 6.58, P < 0.01, the experimental group had significantly higher incidence of complications.

CONCLUSIONFor I and II differentiated thyroid cancer, total thyroidectomy or subtotal resection may reduce the chance of recurrence, but the postoperative complications is higher; while gland lobe and isthmus lobectomy has lower postoperative complications, but may increase the risk of relapse.

Humans ; Neoplasm Recurrence, Local ; epidemiology ; Postoperative Complications ; epidemiology ; Thyroid Neoplasms ; pathology ; surgery ; Thyroidectomy ; adverse effects ; methods

To investigate the risk factors for hypoparathyroidism after thyroidectomy.
 Methods: Clinical data of 492 patients, who underwent thyroidectomy from April 2015 to December 2016 from Xiangya Hospital of Central South University, were studied retrospectively. Chi-square test and multivariable logistic regression were performed to find the risk factors for postoperative hypoparathyroidism.
 Results: The incidence of postoperative hypoparathyroidism was 43.5%, and the incidence of temporary and permanent hypoparathyroidism was 43.1% and 0.4%, respectively. Univariate analysis showed that tumor pathology, thyroidectomy types, the extent of lymph node dissection, application of carbon nanoparticles, and merged Hashimoto's thyroiditis were risk factors for postoperative hypoparathyroidism (all P<0.01). Logistic regression analysis showed that: thyroidectomy types (OR=0.149, 95% CI 0.078 to 0.28), the extent lymph node dissection (OR=0.779, 95% CI 0.617 to 0.983) and application of carbon nanoparticles (OR=1.729, 
95% CI 1.067 to 2.801) were independent risk factors for postoperative hypoparathyroidism (all P<0.05).
 Conclusion: Hypoparathyroidism is a common complication after thyroidectomy. The incidence of postoperative hypoparathyroidism is significantly increased in patients underwent total thyroidectomy and cervical lymph node dissection. Application of carbon nanoparticles intraoperatively can reduce the incidence of postoperative hypoparathyroidism.
Humans ; Hypoparathyroidism ; surgery ; Postoperative Complications ; Retrospective Studies ; Risk Factors ; Thyroid Neoplasms ; Thyroidectomy

Sclerosing mucoepidermoid carcinoma with eosinophilia (SMECE) is a recently recognized malignant neoplasm of the thyroid gland. About 14 cases of SMECE have been reported and this is the first reported case in Korea. A 57-year-old woman presented with right neck mass for 20 years. Total thyroidectomy was performed under the impression of thyroid carcinoma. The resected thyroid gland showed a poorly circumscribed hard mass. Histologically, the tumor consisted of solid nests of large atypical cells with dense fibrous stroma. The tumor cells showed squamoid appearance with abundant eosinophilic cytoplasm. There were also rare mucin-containing cells within the nests. Within the hyalinized stroma, numerous eosinophils were found. The surrounding thyroid parenchyma displayed Hashimoto's thyroiditis. There was metastasis in a regional lymph node. Two years after initial surgery, she underwent a modified radical neck dissection due to recurrent neck mass. After the radiation therapy for eight weeks, laryngectomy and esophagectomy were performed due to a recurrent carcinoma in the esophageal wall. We report an additional case of SMECE, with metastasis to regional lymph nodes and esophagus. The tumor appears to be more aggressive than previously reported and a correct diagnosis can be rendered by just examining the metastatic lesions.
Carcinoma, Mucoepidermoid/surgery ; Carcinoma, Mucoepidermoid/secondary* ; Carcinoma, Mucoepidermoid/pathology* ; Carcinoma, Mucoepidermoid/complications ; Case Report ; Eosinophilia/pathology ; Eosinophilia/complications* ; Esophageal Neoplasms/surgery ; Esophageal Neoplasms/secondary* ; Female ; Human ; Laryngectomy ; Lymph Nodes ; Middle Age ; Recurrence ; Sclerosis ; Thyroid Gland/pathology* ; Thyroid Neoplasms/surgery ; Thyroid Neoplasms/pathology* ; Thyroid Neoplasms/complications ; Thyroiditis, Autoimmune/complications

OBJECTIVE: To assess and compare the two procedures, total thyroidectomy (TT) and partial thyroidectomy (PT), for papillary thyroid cancer in terms of associated injuries, postoperative complication, recurrence rate and survival, so as to provide a reference and basis for surgical procedure option of this disease. METHOD: Strictly specified into the exclusion criteria, the combination of computer retrieval and manual retrieval and retrieval systems such as CNKI, Wang Fan, PubMed, central, CBM database. Total thyroidectomy and partial thyroidectomy for the treatment of patients with thyroid papillary cancer related literature were compared, with the retrieval time until December 31, 2013. RESULT: According to the retrieval strategy 4630 literatures were found, and 20 witch matched the exclusion criteria were left, all were retrospective study. TT and PT group of recurrent laryngeal nerve injury rate are 5.9%, 2.0% respectively [OR = 0.39, 95% CI (0.17 - 0.90), P < 0.05], TT and PT group of parathyroid injury rate are respectively 4.9%, 0.8% respectively [OR = 0.23, 95% CI (0.08 - 0.68), P < 0.01]. The TT group of 10 years survival rate is 95.24% - 100%, and the PT group is 96.8% - 99.2% [OR = 0.03, 95% CI (0 - 0.34), P < 0.01]. Unstaged, unstaged TT group' postoperative recurrence rate is 4.7%, while PT group is 12.6% [OR = 3.21, 95% CI (1.57 - 6.57), P < 0. 01]. Postoperative recurrence of stage I TT group and PT group are 4.9%, 7.8% respectively [OR = 3.82, 95% CI (1. 07-13.66) P < 0.05]; The rate of stage II TT group is 0.5%, while the rate of PT group is 15.9% [OR = 17.23, 95% CI (4.03 - 73.73), P < 0.01]. CONCLUSION Different methods of primary thyroid papillary carcinoma surgical treatment can all obtaina good survival, but the rate of laryngeal recurrent nerve injury and parathyroid injury caused by partal throidectomy is relatively lower. As a result, partial thyroidectomy can be a good choice for early stage thyroid papillary carcinoma.
Carcinoma ; surgery ; Carcinoma, Papillary ; Humans ; Neoplasm Recurrence, Local ; Parathyroid Glands ; Postoperative Complications ; Recurrent Laryngeal Nerve Injuries ; Retrospective Studies ; Survival Rate ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; surgery ; Thyroidectomy ; methods

OBJECTIVETo study the diagnoses and treatments of small thyroid nodules (maximum diameter < 1 cm) with contralateral papillary thyroid microcarcinoma (PTMC).

METHODSA total of 253 patients with unilateral PTMC and contralateral thyroid benign nodules identified by ultrasound before thyroidectomy was retrospectively analysed. All patients underwent near-total or total thyroidectomy. Chi-square test was used for univariate analysis and logistic regression test for multivariate analysis.

RESULTSIn 53 (20.9%) of 253 patients with unilateral PTMC, the contralateral thyroid benign nodules identified by ultrasound were confirmed pathologically as PTMC. Univariate analysis showed multifocality of the primary tumor and Hashimoto's thyroiditis were correlated with contralateral PTMC (χ(2) = 24.834, χ(2) = 5.182, P < 0.05). However, there were no significant differences for the existence of contralateral PTMC in age, sex, tumor size, capsule invasion, lymph node metastasis, the number of nodules and Tg-level. Multivariate analysis showed only multifocal PTMC was an independent predictive factor for contralateral PTMC (OR = 5.352, P < 0.05).

CONCLUSIONSThe patients with unilateral multifocal PTMC have a high rate of PTMC in contralateral small thyroid nodules. However, it is very difficulty to define by ultrasonography preoperatively. The total thyroidectomy maybe serve as a useful treatment.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Papillary ; complications ; diagnostic imaging ; surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Thyroid Neoplasms ; complications ; diagnostic imaging ; surgery ; Thyroid Nodule ; complications ; diagnostic imaging ; surgery ; Ultrasonography ; Young Adult

The aim of this study was to investigate the complications following surgical treatment of thyroid cancer and the association between the extent of surgery and complication rates. A total of 2,636 patients who underwent surgery due to thyroid cancer were retrospectively reviewed to identify surgical complications. Complication rates were assessed according to the extent of surgery, which was classified as follows; less-than-total thyroidectomy with central compartment node dissection (CCND) (Group I, n=636), total thyroidectomy with CCND (Group II, n=1,390), total thyroidectomy plus ipsilateral neck dissection (Group III, n=513), and total thyroidectomy plus bilateral neck dissection (Group IV, n=97). The most common surgical complication was symptomatic hypoparathyroidism, of which 28.4% of cases were transient and 0.3% permanent. The other surgical complications included vocal cord palsy (0.7% transient, and 0.2% permanent), hematoma (0.5%), seroma (4.7%), chyle fistula (1.8%), and Horner's syndrome (0.2%). The complication rates increased significantly with increasing the extent of surgery from Group I to Group IV. The more extensive surgery makes more complications, such as hypoparathyroidism, seroma, and others.
Adult ; Female ; Humans ; Hypoparathyroidism/etiology ; Male ; Middle Aged ; Paralysis/etiology ; Parathyroid Glands/surgery ; *Postoperative Complications ; Retrospective Studies ; Seroma/etiology ; Thyroid Neoplasms/*complications/pathology/*surgery