Thermal ablation has proven an effective treatment modality for certain thyroid diseases. However, its indications remain the subject of significant debate both domestically and internationally. Over recent years, several international academic organizations have issued consensus statements, position papers, and guidelines concerning thyroid thermal ablation. In China, the Chinese College of Interventionalists (CCI), in collaboration with other relevant academic organizations, released the "Expert consensus on thermal ablation for thyroid benign nodes, microcarcinoma and metastatic cervical lymph nodes (2018 edition)". This consensus statement received widespread recognition within the field and contributed significantly to the standardization of thyroid thermal ablation therapy in China. With the continuous accumulation of evidence-based medical data, the need for a more stringent and standardized approach to thyroid thermal ablation has become evident. Accordingly, the Interventional Ultrasound Committee of the CCI, in collaboration with multiple academic organizations and experts, conducted extensive discussions and multiple revisions before finalizing the "Multidisciplinary expert consensus on thermal ablation for benign thyroid diseases, low-risk thyroid carcinoma, and metastatic cervical lymph nodes (2025 edition)". This updated consensus builds on the framework of the 2018 edition, refining indications and contraindications, emphasizing standardized treatment, and outlining future directions for research and clinical applications of thyroid thermal ablation technology.
Humans ; Thyroid Neoplasms/surgery* ; Consensus ; Lymphatic Metastasis ; Lymph Nodes/pathology* ; Thyroid Diseases/surgery*

Objective:Compare the difference of Pharyngocutaneous fistula after total laryngectomy using thyroid gland flap and traditional strip muscle repair, find an effective way to reduce Pharyngocutaneous fistula after total laryngectomy. Methods:Sixty patients with locally advanced laryngeal malignancies were randomly divided into two groups with 30 cases in each group. After total laryngectomy, the experimental group was repaired with thyroid gland flap, and the control group was repaired with traditional strap muscle. Data of gender, age, intraoperative blood loss, operation time, neck lymph node dissection, combined diabetes mellitus, postoperative hypoproteinemia, tumor stage, repair mode and postoperative Pharyngocutaneous fistula were collected in the two groups. The incidence of Pharyngocutaneous fistula in the two groups was compared, and the independent risk factors of Pharyngocutaneous fistula after total laryngectomy were found by logistic regression analysis. Results:The incidence of Pharyngocutaneous fistula after total laryngectomy was 3.3%（1/30） in patients with thyroid gland flap repair and 26.7% （8/30） in patients with traditional strip muscle repair, with statistically significant difference（P<0.05）. There was no significant correlation between gender, age, maximum tumor diameter, blood loss, operation time and Pharyngocutaneous fistula. Hypoproteinemia and repair mode were correlated with pharyngocutaneous fistula. Repair mode is an independent risk factor for Pharyngocutaneous fistula after total laryngectomy. Conclusion:The occurrence of Pharyngocutaneous fistula after total laryngectomy was decreased significantly by using pedicle thyroid flap compare to traditional surgery.The Pedicle thyroid flap can be considered as an effective clinical repairment to reduce postoperative Pharyngocutaneous fistula.
Humans ; Laryngectomy/methods* ; Male ; Cutaneous Fistula/prevention & control* ; Female ; Postoperative Complications/etiology* ; Surgical Flaps ; Laryngeal Neoplasms/surgery* ; Middle Aged ; Thyroid Gland/surgery* ; Pharyngeal Diseases/prevention & control* ; Fistula/prevention & control* ; Risk Factors

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

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

Cornus ; Deglutition Disorders ; Humans ; Laryngeal Diseases ; Neck Injuries ; Thyroid Cartilage/surgery*

Ophthalmic plastic and reconstructive surgery combines the precision of ophthalmic microsurgery with plastic and reconstructive surgical principles, allowing for subspecialized care of the eyelid, orbital, and lacrimal system. A foundation in ophthalmology allows the oculoplastic surgeon's knowledge and skills to safely and successfully protect the globe while achieving good functional and aesthetic results. Oculoplasty emerged following World War II, in which a high rate of ophthalmic and oculoplastic trauma occurred. Following this, more structured and specialized studies dedicated to clinical and surgical management led to the development of a highly specific and rapidly growing sub-specialty dedicated to eyelid, lacrimal, and orbital care. Stem cell treatments in oculoplasty has been spanned a wide array of subfields, ranging from reconstruction of the eyelid to the generation of artificial lacrimal glands and oncological therapeutics. Tissue engineering represents the future of regenerative and reconstructive medicine, with significant potential applications in ophthalmic plastic surgery. Difficulty remains in disease modeling for various disorders, owing to genetic and functional variation across patients as well as the complexity of several diseases. Progressive advances in the understanding of the immunopathogenesis of diseases such as thyroid eye disease and lacrimal gland carcinoma continue to spur clinical trials utilizing targeted therapies to enhance treatment outcomes. Continued investigation of the molecular mechanisms of disease will expand potential treatments. In the future, public awareness and interest in the field of oculoplasty will further grow, and personalized and optimized treatment will become a cornerstone of modern medicine.
Eye Diseases ; Eyelids ; Graves Ophthalmopathy ; History, Modern 1601- ; Humans ; Lacrimal Apparatus ; Microsurgery ; Ophthalmology ; Orbit ; Plastics ; Stem Cells ; Surgery, Plastic ; Thyroid Gland ; Tissue Engineering ; World War II

The da Vinci S surgical system (Intuitive Surgical) was approved as a medical device in 2009 by the Japanese Ministry of Health, Labour and Welfare. Robotic surgery has since been used in gastrointestinal, thoracic, gynecological, and urological surgeries. In April 2012, robotic-assisted laparoscopic radical prostatectomy (RALP) was first approved for insurance coverage. Since then, RALP has been increasingly used, with more than 3,000 RALP procedures performed by March 2013. By July 2014, 183 institutions in Japan had installed the da Vinci surgical system. Other types of robotic surgeries are not widespread because they are not covered by public health insurance. Clinical trials using robotic partial nephrectomy and robotic gastrectomy for renal and gastric cancers, respectively, have recently begun as advanced medical treatments to evaluate health insurance coverage. These procedures must be evaluated for efficacy and safety before being covered by public health insurance. Other types of robotic surgery are being evaluated in clinical studies. There are several challenges in robotic surgery, including accreditation, training, efficacy, and cost. The largest issue is the cost-benefit balance. In this review, the current situation and a prospective view of robotic surgery in Japan are discussed.
Cost-Benefit Analysis ; Esophageal Neoplasms/surgery ; Gastrectomy/*methods ; Gynecologic Surgical Procedures/methods ; Humans ; Japan ; Laparoscopy/*methods ; Nephrectomy/*methods ; Otolaryngology/methods ; Prospective Studies ; Prostatectomy/*methods ; Rectal Neoplasms/surgery ; Robotic Surgical Procedures/education/*trends ; Stomach Neoplasms/surgery ; Thymectomy/methods ; Thyroid Diseases/surgery

OBJECTIVE: To investigate the clinical feature,diagnostic and therapeutic methods of ultimobranchial fistula and cyst of thyroid. METHOD: Four cases of ultimobranchial fistula and cyst of thyroid in our hospital were reported and the relevant literatures were reviewed. RESULT: The branchial fistula and cyst of four cases were adhered to thyroid,with unclear anatomical landmarks, the function of recurrent laryngeal nerve were bad before the operation in two cases. The nerve of four cases were retained, the function of thyriod and parathyroid gland were normal and no recurrence were found. CONCLUSION Ultimobranchial fistula and cyst of thyroid is rare and is easier to be misdiagnosed and wrong treated. Surgical excision is effective for it and recurrent laryngeal nerve should be protected when performing the operation.
Cysts ; Diagnostic Errors ; Fistula ; Humans ; Parathyroid Glands ; Recurrent Laryngeal Nerve ; Thyroid Diseases ; pathology ; surgery

OBJECTIVE: To study the anatomic characteristics of recurrent laryngeal nerve during thyroid surgery. METHOD: A retrospective review of surgical data of 307 patients undertook thyroid surgery was conducted. RESULT: Total 342 recurrent laryngeal nerves were identified during the surgery(184 on the right side, left 158). 215 (62.9%) nerves were deep to the inferior thyroid artery, 106(31.0%)were superficial to the artery, 21(7.5%) were between the arterial branches. A nerve bifurcation was found in 203(59.4%). None of nerve bifurcation was found in 136(39.8%). 3(0.9%)were confirmed to hold non-recurrent laryngeal nerves during operations. No patient showed permanent laryngeal recurrent nerve paralysis postoperatively. CONCLUSION The careful dissection and protection of the recurrent laryngeal nerve was an effective method to prevent its injury during thyroid surgery.
Arteries ; Cranial Nerve Diseases ; etiology ; prevention & control ; Dissection ; Humans ; Postoperative Period ; Recurrent Laryngeal Nerve ; Retrospective Studies ; Thyroid Gland ; surgery ; Thyroidectomy ; Vocal Cord Paralysis

p style=text-align: justify;strongOBJECTIVE:/strong To evaluate the necessity of placing a drain in post-thyroidectomy patients, we aimed to determine whether insertion of a passive drain as compared to no drain in post-thyroidectomy patients would significantly affect hematoma formation, wound infection, wound dehiscence and length of hospital stay.METHODS:br /Design:/strong Prospective randomized controlled trialbr /strongSetting:/strong Tertiary government training hospitalbr / strongSubjects:/strong Patients who underwent thyroidectomy for various pathologies were divided into two postoperative treatment arms: one group with insertion of a passive drain, and another group without a drain. Hematoma, wound infection, wound dehiscence and length of hospital stay were the outcomes measured per treatment arm.RESULTS:/strong A total of 66 patients were evaluated. There were 54 females (81.81%) and 12 males (18.18%). The mean age for the drain group was 44.88 years and 43.67 years for the no drain group. Four patients developed complications in the drain group and two developed complications in the no drain group. The rate of complications between both groups was not statistically significant. The mean hospital stay of the drain group was 3.15 days which in the no drain group was 2.51 days. The difference in length of hospital stay was statistically significant.CONCLUSIONS:/strong There was no difference in the development of complications among the drain and no drain group. Thyroidectomy without surgical drains was associated with a significant reduction in hospital stay compared to thyroidectomy with routine placement of drains./p
Human ; Male ; Female ; Aged 80 and over ; Aged ; Middle Aged ; Adult ; Thyroid Diseases ; Thyroidectomy-surgery ; Drainage ; Postoperative Care ; Thyroid Gland ; Postoperative Complications ; Hematoma