* If you want to update the article please login/register
Background Information The transoral endoscopic thyroidectomy vestibular approach is limited in terms of training methods. Our goal was to develop and analyze a TOETVA training scheme for general and ENT surgeons. Methods The study used a total of 15 modified Larssen solution human cadavers. In two years in a row, two-year TOETVA human cadaver workshops were held. Both trainers were trained with verbal and online questionnaires to determine course structure and program, organoleptic characteristics of MLS-fixed human cadavers, and TOETVA training effectiveness. Both the trainers and teachers were u201cpractical, according to a 31 percent increase in trainees for all steps of TOETVA, with respect to human cadaver and teaching quality. This is half of all TOETVA workshops, with repeatable use of MLS-fixed human cadaver. Conclusions The TOETVA human cadaver workshop model hasn't been announced as of yet.
Source link: https://doi.org/10.1007/s00464-022-09224-8
The Transoral Endoscopic Thyroidectomy Vestibular Approach is a natural orifice transluminal endoscopic surgery that provides a safe alternative to thyroidectomy. Methods Case study of four surgeons at three separate hospitals were investigated in the initial TOETVA procedures of four surgeons. For a total of 130 cases, each surgeon performed between 23 and 40 TOETVA procedures. Binary logistic regression shows a negative correlation between case number and complication rate despite a positive correlation. A negative relationship between case number and complication severity is shown by continuous logistic regression, which is inconsistent. At case number 12 of the maximum slope of increase in complication rate occurred. Conclusion At case 12: The most significant reduction in TOETVA symptoms for TOETVA has been observed. There has been a substantial decrease in both the risk of a complication and the severity of the infection as case number increases. These findings are consistent with earlier reported TOETVA learning curve estimates based on operative time.
Source link: https://doi.org/10.1007/s00464-021-08832-0
Background We often saw that patients who underwent total thyroidectomy due to clinically related nodal disease had less extensive CLNM on final pathology in clinical practice. This report explores whether complete thyroidectomy and therapeutic bilateral CND are required for all PTC patients with cN1a. Methods This review retrospectively reviewed 899 PTC patients who underwent total thyroidectomy with bilateral CND from January 2012 to June 2017. After a mean follow-up time of 59. 1 months, there was no significant difference in recurrence between cN0 and cN1a groups. unilateral cN1a, on the other hand, was not associated with an elevated risk of contralateral lobe involvement and contralateral CLNM. Among 106 unilateral cN1a patients, 33 were pN0 or had u2264 5 metastatic CLNs with the largest node smaller than 2 mm. However, lobectomy with CND may have been successful in approximately 30% of the cn1a patients.
Source link: https://doi.org/10.1186/s12893-022-01699-5
Purpose of Study The aim of this review was to determine the characteristics of patients who underwent transoral robotic thyroidectomy in the global literature, particularly in comparative studies with a vestibular approach to help identify the correct patient. This review paper seeks to evaluate both the main comparative studies involving TORT and TOETVA patients and those involving cohorts of patients operated by TORT, always paying attention to the inclusion and exclusion criteria used.
Source link: https://doi.org/10.1007/s40137-022-00321-0
This study sought to compare the results of local spray and perineural injection surrounding the internal branch of superior laryngeal nerve in the prevention of POST and alleviating postoperative impaired voice function. Randomly assigned to two groups of 161 patients who underwent elective thyroidectomy. 3 mg dexamethasone was sprayed onto the vocal cord; Group iSLN: bilateral perineural injection with 4 mg dexamethasone around the iSLN; As compared to Group Spray, Group iSLN improved postoperative voice quality, which was characterized by lower jitter and lower shimmer value at 6 h and 24 hours after the operation. Compared to the local spray, patients undergoing elective thyroidectomy or those who received perineural injection around iSLN with dexamethasone had increased voice clarity and stood out for more excellence in the reduction of POST and cough.
Source link: https://doi.org/10.1007/s00405-022-07513-5
One of the cough control steps used during recovery is Remifentanil administration by target-controlled infusion. Lidocaine was also found to reduce cough when using a dual-cuff endotracheal tube in a pilot study. In a single-centre, double-blind, randomised survey conducted in China between 09/10/2021 and 30/04/2021, we therefore compared these two cough prevention strategies during thyroidectomy reconstruction. Patients were randomly assigned either 4 ml of saline solution or 4 ml of 2% lidocaine in the outer cuff at the start of skin suturing. In Group R until extubation, Remifentanil was maintained, but remifentanil was maintained in Group L until the time of skin suturing. After thyroidectomy, Lidocaine was particularly effective in female patients following thyroidectomy.
Source link: https://doi.org/10.1186/s12871-022-01734-1
Background in recent years Endoscopic selective lateral neck dissection has made strides in endoscopic selective neck dissection. However, dissection of lymph nodes in level IV and VI by the chest approach is inherently difficult. We used combined trans-oral and chest approach for endoscopic thyroidectomy in patients with cT1-2N1bM0 papillary thyroid carcinoma in this study. Methods were retrospectively reviewed to examine ten patients with cT1-2N1bM0 PTC who underwent endoscopic thyroidectomy using a combination of trans-oral and chest approach between September 2020 and September 2021. All 10 patients underwent total thyroidectomy and selective LND via chest biopsy, with central neck dissection and additional lymph nodes at level IV were both performed using the trans-oral technique. Preoperative testing may provide one more alternative for cT1-2N1bM0 PTC patients, particularly those in whom metastatic lymph nodes at level IV or level VI are detected by preoperative investigation.
Source link: https://doi.org/10.1007/s00464-022-09376-7
Purpose Various thyroid pathologies are believed to contribute to obstructive sleep apnea. The underlying mechanisms of the intricate relationship between OSA and thyroid structure and function are unclear, as well as whether thyroidectomy can alleviate OSA symptoms. An analysis of the effects of thyroidectomy on OSA is warranted. Methods An systematic review of four electronic databases was done up to February 2022. Study Six cohort studies on 221 OSA patients who underwent thyroidectomies were included in six cohort studies. The results showed that thyroidectomy was associated with significant reductions in postoperative AHI, but that no significant correlation was found with CPAP withdrawal. Neither the Berlin questionnaire test result nor the ESS improved postoperatively. Conclusions This meta-analysis provides a quantitative estimate of the effects of the thyroidectomy on OSA, along with the finding that thyroidectomy is not related to limited clinical improvement of polysomnographic outcomes.
Source link: https://doi.org/10.1007/s00405-022-07461-0
Although a thoracoscopic approach to thyroid goiters with mediastinal extension has been carried out in several hospitals, remote-access thyroidectomy for cervicomediastinal goiters has yet to be carried out, although remote-access thyroidectomy for cervicomediastinal goiters has yet to be performed. Patients and methods Patients and methods In Japan, patients with CMGs who consented to an axillo-thoracic endoscopic thyroidectomy at one of two hospitals underwent a remote-access thyroidectomy. The axillo-thoracic endoscopic right or left hemithyroidectomy was a success, but the majority of patients did not require the thoracoscopic procedure. Conclusions The majority of thyroid goiters with substernal extension can be removed by the axillary method, but some cases necessitate a thoracoscopic approach.
Source link: https://doi.org/10.1007/s00423-022-02579-5
Background For unilateral papillary thyroid carcinoma patients with contralateral benign nodules, optimal treatment decisions are made according to patient preference and the disease's pathological characteristics. Comparing to total thyroidectomy, this review was conducted to determine the effectiveness and complications of hemithyroidectomy with intraoperative radiofrequency ablation relative to total thyroidectomy. Patients with unilateral PTC and cytologically benign contralateral nodules were recruited from 2014 to 2018. Patients with persistent thyroidectomy or hemithyroidectomy with intraoperative RFA of the contralateral nodule were given to patients who were concerned about their illness. 191 patients who underwent total thyroidectomy and 224 contralateral nodules in 191 patients underwent intraoperative RFA were included in the hemithyroidectomy with intraoperative RFA. Within one year, the total thyroidectomy center demonstrated significantly higher hypocalcemia than HTRFA. One year after HTRFA, supplemental levothyroxine was not used in 28. 3% of the patients.
Source link: https://doi.org/10.1186/s40463-022-00578-6
* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions