Objective To observe postoperative effect of electroacupuncture（EA） of different frequencies in acupuncture anesthesia combined with drugs on patients undergoing thyroid surgery.Methods One hundred and twenty patien...Objective To observe postoperative effect of electroacupuncture（EA） of different frequencies in acupuncture anesthesia combined with drugs on patients undergoing thyroid surgery.Methods One hundred and twenty patients undergoing thyroid surgery were randomly divided into a 2Hz electroacupuncture anesthesia group（group A）,a 100 Hz electroacupuncture anesthesia group（group B）,a 2Hz/100 Hz electroacupuncture anesthesia group（group C） and a cervical plexus block group（group D） in accordance with the random number table method,with 30 patients in each group.In group A,group B and group C,electroacupuncture was applied at bilateral Futu（扶突 LI 18）,Hegu（合谷 LI 4） and Neiguan（内关 PC 6） at frequencies of 2 Hz,100 Hz and 2 Hz/100 Hz respectively for 30 min.The needles were retained till the end of the surgery.Dolantin and atropine were intramuscularly injected In group D,bilateral cervical plexus block was produced with a mixture of1%lidocaine and 0.375%bupivicaine.Before surgery,pain threshold and threshold of pain tolerance were determined;during surgery,the duration of surgery was recorded;and after surgery,QOLS（Quality Of Life Score） and PHS（Prince-Henry Score） were assessed.Results PHS in group A,group B and group C were lower than that in group D,respectively（0.20±0.41,0.17±0.38,0.10±0.31 vs 0.40±0.50,P〈0.01）,and PHS in group C was lower than those in group A and group B,respectively（both P〈0.01）.QOLS in group A,group B and group C were higher than that in group D,respectively（9.97±1.07,9.97±2.27,10.40±1.45 vs 9.73±1.41,P〈0.05,P〈0.01）,and QOLS in group C was higher than those in group A and group B,respectively（both P〈0.05）.Conclusion Acupuncture anesthesia combined with drugs has better postoperative effect than drug anesthesia.Electroacupuncture of different frequencies can significantly improve general quality of life of patients,so patients recover well after thyroid surgery.As patients in group C suffered from the slightest pain with the highest quality of life,they recovered best within the shortest time.Electroacupuncture at frequency of 2 Hz/100 Hz can better play postoperative analgesic effect.展开更多
In the present study, we aimed to evaluate the intervention effect of prophylactic antibiotic use in thyroid surgery in a large hospital. From 2004 to 2012, 70 patients who underwent thyroid surgery were randomly sele...In the present study, we aimed to evaluate the intervention effect of prophylactic antibiotic use in thyroid surgery in a large hospital. From 2004 to 2012, 70 patients who underwent thyroid surgery were randomly selected each year. The quality of surgical antibiotic prophylaxis （SAP） was assessed each year in terms of antibiotic ratio, choice, duration, timing, combination, route of administration and so on. The result showed that the SAP ratio was 100% from 2004 to 2010. With our intervention, this SAP ratio was decreased to 45.7% in 2011, and it reached 2.9% in 2012. The AUD was consistently greater than 38 before 2010, while it rapidly declined to 1 in 2012. The number of DDDs per 100 operations was decreased from 431 to 3 after the intervention. The average cost of antibiotic drugs per patient was RMB 350.65 in 2010, whereas it was decreased to RMB 18.51 in 2012. The average duration of hospitalization showed no difference during the intervention. This study indicated that implementation of a multi-disciplinary protocol and clinical pharmacist interventions could improve the rational use of SAP.展开更多
Objective To report a case of the implantation of thyroid hyperplastic or neoplastic tissue after endoscopic thyroidectomy and discuss this complication in aspects of prevalence, pathogenesis, protection, and therapie...Objective To report a case of the implantation of thyroid hyperplastic or neoplastic tissue after endoscopic thyroidectomy and discuss this complication in aspects of prevalence, pathogenesis, protection, and therapies. Methods A systematic search of literature from the PubMed database was conducted for identifying eligible studies on implantation of thyroid hyperplastic or neoplastic cells after endoscopic thyroid surgery. Results Overall, 5 reported cases on patients suffering from endoscopic thyroid surgery with implantation of thyroid hyperplastic or neoplastic cells were included in the systematic review. Conclusions Unskilled surgeons, rough intraoperative surgical treatment, scarification or rupture of tumor, contamination of instruments, chimney effect, aerosolization of tumor cells may be associated with the implantation after endoscopic thyroidectomy. To minimize the risk of such complication, we should be more meticulous and strict the endoscopic surgery indications.展开更多
Objective: to observe the therapeutic effect of dexamethasone palmitate injection on hoarseness caused by recurrent laryngeal nerve injury during thyroid surgery. Methods: 783 patients were divided into treatment grou...Objective: to observe the therapeutic effect of dexamethasone palmitate injection on hoarseness caused by recurrent laryngeal nerve injury during thyroid surgery. Methods: 783 patients were divided into treatment group (395 cases) and control group (388 cases). After thyroidectomy, the treatment group was sprayed with dexamethasone palmitate injection 1ml:4mg, while the control group was not sprayed with any drugs. The patients' hoarseness was observed on the 1st, 3rd, 7th and 30th day after operation. The GRBAS score, voice disorder index and VHI-13 Chinese version scale were used to evaluate the patients' voice. At the same time, the occurrence of severe adverse drug reactions, upper abdominal pain and hyperglycemia within 7 days after operation, and the infection in the operation area within 30 days after operation were observed. Results: the hoarseness in the treatment group was less than that in the control group on the 1st, 3rd and 7th day after operation (p<0.05), and there was no significant difference between the two groups on the 30th day after operation (p>0.05). There was no serious adverse drug reaction in the treatment group, upper abdominal pain and hyperglycemia within 7 days after operation, and there was no significant difference between the two groups within 30 days after operation (p>0.05). Conclusion: local application of dexamethasone palmitate injection during thyroid surgery has a certain therapeutic effect on reducing hoarseness caused by recurrent laryngeal nerve injury, but it has a limited therapeutic effect on recurrent laryngeal nerve injury which has not recovered its voice 30 days after operation.展开更多
Objective: to explore the application effect of neural monitor combined with nursing intervention in patients with thyroid surgery. Methods: 60 patients with thyroid surgery in our hospital from November 2019 to Novem...Objective: to explore the application effect of neural monitor combined with nursing intervention in patients with thyroid surgery. Methods: 60 patients with thyroid surgery in our hospital from November 2019 to November 2020 were randomly divided into two groups by digital table method. The control group was given routine nursing, and the research group was given neural monitor combined nursing intervention. The scores of unhealthy emotions, Pittsburgh sleep quality score and the incidence of recurrent nerve injury were compared between the two groups before and after nursing. Results: the score of unhealthy emotions in the study group was lower than that in the control group, the Pittsburgh sleep quality score was lower than that in the control group, and the incidence of recurrent nerve injury was lower than that in the control group, P < 0.05. Conclusion: neural monitor combined with nursing intervention is effective in patients with thyroid surgery, which can reduce unhealthy emotions, improve sleep quality and reduce complications.展开更多
Objectives:Tracheomalacia is defined as the weakening of the tracheal rings secondary to long-standing compression or inherent structural weakness,leading to stridor and airway compromise.The common etiological factor...Objectives:Tracheomalacia is defined as the weakening of the tracheal rings secondary to long-standing compression or inherent structural weakness,leading to stridor and airway compromise.The common etiological factor of tracheomalacia includes compression of the tracheal framework due to a large multinodular goiter.There are various management techniques described in the literature to manage a patient with tracheomalacia including tracheostomy,tracheal stenting,and tracheopexy.However,the evidence of tracheomalacia in the literature is conflicting.Therefore,a systematic review was conducted to estimate the incidence of tracheomalacia after thyroidectomy.Methods:The systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines.A literature search was performed on PubMed,Web of Science,Cochrane library,and Elton B.Stephens Co.cumulative index to nursing and allied health literature plus to determine the incidence of tracheomalacia among patients undergoing thyroidectomy up till October 2021.The eligibility was assessed by two independent authors.A quality assessment of individual studies was performed using the National Institute of Health quality assessment tool.Outcomes were double data extracted and were analyzed using OpenMeta.Results:The online search retrieved 214 papers,out of which 17 studies were included that fulfilled the eligibility criteria.The number of patients included in the systematic review who underwent thyroidectomy was 1108.The mean age was 55.8±7.7 years,ranging from 48 to 75 years.Tracheomalacia was reported in 146 patients(1.4%).Sternotomy was performed in 102 patients to approach the goiters with retrosternal extension.The most common intervention to manage tracheomalacia was tracheostomy or prolonged intubation.Conclusions:Tracheomalacia is a rare complication.In cases where tracheomalacia is encountered,common methods of management include tracheostomy or prolonged endotracheal intubation.Prospective,long-term studies are required to accurately assess its true incidence and associated factors.展开更多
Objective Robot-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...Objective Robot-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.展开更多
Objective:To evaluate the effectiveness and safety of electroacupuncture in conjunction with additional medications in providing analgesia and stabilizing hemodynamic parameters during total thyroidectomy.Methods:This...Objective:To evaluate the effectiveness and safety of electroacupuncture in conjunction with additional medications in providing analgesia and stabilizing hemodynamic parameters during total thyroidectomy.Methods:This randomized controlled trial included 100 patients who underwent a total thyroidectomy between October 2022 and October 2023 at the Vietnam National Hospital of Acupuncture.The patients were randomized into two groups.The electroacupuncture analgesia(EA)group received EA stimulation at five acupuncture points:Hegu(LI 4),Neiguan(PC 6),Shuitu(ST 10),Quepen(ST 12),and Yifeng(SJ 17),while the control group received a bilateral superficial cervical plexus block.Primary outcomes included the level of analgesia and perioperative vital signs in both groups.Additionally,pain thresholds and serum b-endorphin levels were measured before and after electroacupuncture in the EA group.Results:Complete analgesia(Level A)was attained in 86%and 76%of the patients in the EA and control groups,respectively,with no significant difference between the two groups(P=1.00).In the EA group,the mean pain threshold after receiving EA doubled(648.7(77.4)g/s vs.305.3(45.3)g/s,P<.001),and the mean serum b-endorphin level increased by approximately 13.5 pg/mL(P<.001).All patients remained hemodynamically stable throughout the surgery.Conclusion:EA,in conjunction with additional medications that stimulate five acupuncture points,LI 4,PC 6,ST 10,ST 12,and SJ 17,was well tolerated and effectively maintained a suitable level of analgesia and hemodynamic stability during total thyroidectomy.展开更多
Objective: to explore the importance and key points of negative pressure attraction nursing for incision after thyroid and mammary gland surgery. Methods: this study targeted patients with thyroid cancer, breast cance...Objective: to explore the importance and key points of negative pressure attraction nursing for incision after thyroid and mammary gland surgery. Methods: this study targeted patients with thyroid cancer, breast cancer and hyperthyroidism from August 2020 in 20 to August 2021, and the total number of cases selected was 84.After the consent of the study subjects and family members, the above 84 study subjects according to the hospitalization number, take random digital table method randomly divided into the two trial groups, including postoperative incision negative pressure attraction during the control group, postoperative incision negative pressure attraction to professional negative pressure attraction care group called the observation group. Comparative analysis of the effects of the two groups under different modes of care was conducted. Results: (1) Compared with the postoperative drainage-related indicators of the control group, the observation group had significantly lower drainage flow rate and shorter drainage time and hospitalization time under professional negative pressure attraction care. The comparison between the above drainage-related indicators was quite different, and the obtained P-value was lower than 0.05.(2) Compared with the pre-nursing pain score between the two groups, there was no significant difference, and the P-value was higher than 0.05;the pain score was decreased, but the observation group was significantly lower than the control group, and the difference between groups was large, and the P-value was lower than 0.05.(3) Compared with the two postoperative sleep quality scores, there was no significant difference, and the P-value was higher than 0.05;the two groups were lower, but the observation group was significantly lower than the control group, and the P-value was lower than 0.05.(4) The observed group had a lower incidence of postoperative complications compared with the control group, the comparison difference between groups was large, and the obtained P-value was lower than 0.05.Conclusion: during the period of incision negative pressure attraction after thyroid gland surgery, the use of professional negative pressure attraction care measures is more conducive to promote patients' rehabilitation, relieve postoperative pain, and reduce the incidence of postoperative and occurrence, which is worth actively cited in clinical time.展开更多
Hypoparathyroidism is one of the main complications after total thyroidectomy,severely affecting patients’quality of life.How to effectively protect parathyroid function after surgery and reduce the incidence of hypo...Hypoparathyroidism is one of the main complications after total thyroidectomy,severely affecting patients’quality of life.How to effectively protect parathyroid function after surgery and reduce the incidence of hypoparathyroidism has always been a key research area in thyroid surgery.Therefore,precise localization of parathyroid glands during surgery,effective imaging,and accurate surgical resection have become hot topics of concern for thyroid surgeons.In response to this clinical phenomenon,this study compared several different imaging methods for parathyroid surgery,including nanocarbon,indocyanine green,near-infrared imaging techniques,and technetium-99m methoxyisobutylisonitrile combined with gamma probe imaging technology.The advantages and disadvantages of each method were analyzed,providing scientific recommendations for future parathyroid imaging.In recent years,some related basic and clinical research has also been conducted in thyroid surgery.This article reviewed relevant literature and provided an overview of the practical application progress of various imaging techniques in parathyroid surgery.展开更多
BACKGROUND Thyroglobulin(Tg)is one of the markers of thyroid cancer,and its concentration may be elevated in patients with malignant thyroid tumors.Thyroid-stimulating hormone(TSH)is secreted by the pituitary gland,wh...BACKGROUND Thyroglobulin(Tg)is one of the markers of thyroid cancer,and its concentration may be elevated in patients with malignant thyroid tumors.Thyroid-stimulating hormone(TSH)is secreted by the pituitary gland,which has a significant impact on thyroid gland function.Excessively high or low TSH levels may be associated with an increased risk of thyroid cancer.Thus,in-depth studies on the association of serum Tg and TSH levels with thyroid cancer risk in patients with thyroid nodules are warranted.This can help determine whether Tg and TSH levels can predict the degree of malignancy of thyroid nodules,which can in turn guide doctors in making accurate diagnoses and treatment decisions.Furthermore,such studies can provide more accurate diagnostic methods for thyroid nodules and help patients become aware of the presence of thyroid cancer as early as possible,thereby improving the success rate of treatment and prognosis.AIM To investigate the association of serum Tg and TSH levels with the risk of thyroid cancer in patients undergoing thyroid nodule surgery.METHODS The clinical data and laboratory examination results of 130 patients who underwent thyroid nodule surgery were retrospectively analyzed.Furthermore,their preoperative serum Tg and TSH levels were recorded.Histopathological examination conducted during follow-up revealed the presence of thyroid cancer.Correlation analysis were used to analyze the association of Tg and TSH levels with the risk of thyroid cancer.RESULTS Of the 130 patients,60 were diagnosed with thyroid cancer.Statistical analysis revealed a significant positive correlation between serum Tg levels and the risk of thyroid cancer(P<0.05).This suggests that high serum Tg levels are associated with an increased risk of thyroid cancer.However,no significant correlation was observed between serum TSH levels and the risk of thyroid cancer(P>0.05).CONCLUSION In patients who underwent thyroid nodule surgery,serum Tg levels exhibited a significant correlation with the risk of thyroid cancer but serum TSH levels did not.These findings suggest that serum Tg can serve as an important biomarker for assessing the risk of thyroid cancer in these patients.展开更多
The purpose of this study was to study the frequency of premature division of the inferior laryngeal nerve and its consequences in thyroid surgery. Methodology: We realized a forward-looking and retrospective study fr...The purpose of this study was to study the frequency of premature division of the inferior laryngeal nerve and its consequences in thyroid surgery. Methodology: We realized a forward-looking and retrospective study from January, 1979 till December, 2017 in the service of surgery B to the University hospital of the Point G of Bamako and in the service of ENT and cervico-facial surgery of the CHU “mother-child”, the Luxembourg of Bamako (Mali). All the patients operated in both services for mild goiters were included. Cancers and other thyroid pathologies were not included. The diagnosis of mild goiter was paused by the histological examination realized on all the surgical specimens. Results: On 2109 dissections of the lower laryngeal nerve realized during the surgical operations on the thyroid 95.1% of the cases, the nerve had a single branch;in 4.1% of the cases, the nerve had two branches;and in 0.8% of the cases, the nerve had more than 2 branches. Conclusion: The complications of the thyroid surgery in touch with the hurts of the lower laryngeal nerve are known. However, our study shows that these do not seem to be influenced by the premature division of the lower laryngeal nerve.展开更多
Objectives:Thyroidectomy is among the most commonly performed head and neck surgeries,however,limited existing information is available on topics of interest and concern to patients.Study Design:Observational.Setting:...Objectives:Thyroidectomy is among the most commonly performed head and neck surgeries,however,limited existing information is available on topics of interest and concern to patients.Study Design:Observational.Setting:Online.Methods:A search engine optimization tool was utilized to extract metadata on Google‐suggested questions that“People Also Ask”(PAA)pertaining to“thyroidectomy”and“thyroid surgery.”These questions were categorized by Rothwell criteria and topics of interest.The Journal of the American Medical Association(JAMA)benchmark criteria enabled quality assessment.Results:A total of 250 PAA questions were analyzed.Future‐oriented PAA questions describing what to expect during and after the surgery on topics such as postoperative management,risks or complications of surgery,and technical details were significantly less popular among the“thyroid surgery”group(P<0.001,P=0.005,and P<0.001,respectively).PAA questions about scarring and hypocalcemia were nearly threefold more popular than those related to pain(335 and 319 vs.113 combined search engine response page count,respectively).The overall JAMA quality score remained low(2.50±1.07),despite an increasing number of patients searching for“thyroidectomy”(r(77)=0.30,P=0.007).Conclusions:Patients searching for the nonspecific term“thyroid surgery”received a curated collection of PAA questions that were significantly less likely to educate them on what to expect during and after surgery,as compared to patients with higher health literacy who search with the term“thyroidectomy.”This suggests that the content of PAA questions differs based on the presumed health literacy of the internet user.展开更多
Background:Transoral vestibular approach thyroidectomy using robotic system has advantages with articulating instrumentation.Transoral robotic thyroidectomy(TORT)can be done either using just two robot arms for instru...Background:Transoral vestibular approach thyroidectomy using robotic system has advantages with articulating instrumentation.Transoral robotic thyroidectomy(TORT)can be done either using just two robot arms for instruments and an extra one for the endoscopic camera,or using three robot arms for instruments(third arm through axila)and an additional arm for the camera.Pros of additional axillary arm for TORT:The 4th arm through an additional axillary port is mainly responsible for a counter-traction of strap muscles and thyroid tissue.The additional axillary port tract is also an excellent passage for the specimen removal with lower risk of disruption or fragmentation.Ultimately,these merits from the additional axillary arm allows TORT to be performed safely in a wide range of patient groups.Cons of additional axillary arm for TORT:One of the issue with the additional axillary arm in TORT is that it leaves a cutaneous scar.Another issue to consider is the cost.In some places,robotic surgery operation fee varies with the number of arms used during the operation.Retraction of strap muscles through subcutaneous stitches applied after establishing the working space may make up for the lack of counter-traction.Conclusion:TORT can be done safely with or without the transaxillary arm and surgeon may consider pros and cons based on multiple factors.展开更多
Background： lntraoperative neuromonitoring （IONM） of the recunent laryngeal nerve （RLN） has been widely applied during thyroid surgery. However, the sale range of stimulation intensity for IONM remains undetermin...Background： lntraoperative neuromonitoring （IONM） of the recunent laryngeal nerve （RLN） has been widely applied during thyroid surgery. However, the sale range of stimulation intensity for IONM remains undetermined, Methods： Total thyroidectomies were performed on twenty dogs, and their RLNs were stimulated with a current of 5 20 mA （step-wise in 5 mA increments） for 1 min. The evoked electromyography （EMG） of vocal muscles before and after supramaximal stimulation were recorded and compared. Acute microstructural morphological changes in the RLNs were observed immediately postoperatively under an electron microscope. Results： The average stimulating threshold for RLNs stimulated with 15 mA and 20 mA showed no significant changes compared to the unstimulated RLNs （15 mA group： 0.320 ± 0.123 mA vs. 0.315 ±0.097 mA, P =0.847; 20 mA group： 0.305 ± 0.101 mA vs. 0.300 ＋ 0.103 mA, P = 0.758）. Similar outcomes were shown in average evoked EMG amplitude （15 mA group： 1,026 ± 268 p.V xs. 1,021 ± 273 p.V, P = 0.834; 20 mA group： 1,162 ± 275 μV vs. 1,200 ± 258μV, P = 0.148）. However, obvious acute microstructural morphological changes were observed in the nerves that were stimulated with 20 mA. Conclusions： A stimulation intensity less than 15 mA might be safe for IONM of the RLN.展开更多
文摘Objective To observe postoperative effect of electroacupuncture（EA） of different frequencies in acupuncture anesthesia combined with drugs on patients undergoing thyroid surgery.Methods One hundred and twenty patients undergoing thyroid surgery were randomly divided into a 2Hz electroacupuncture anesthesia group（group A）,a 100 Hz electroacupuncture anesthesia group（group B）,a 2Hz/100 Hz electroacupuncture anesthesia group（group C） and a cervical plexus block group（group D） in accordance with the random number table method,with 30 patients in each group.In group A,group B and group C,electroacupuncture was applied at bilateral Futu（扶突 LI 18）,Hegu（合谷 LI 4） and Neiguan（内关 PC 6） at frequencies of 2 Hz,100 Hz and 2 Hz/100 Hz respectively for 30 min.The needles were retained till the end of the surgery.Dolantin and atropine were intramuscularly injected In group D,bilateral cervical plexus block was produced with a mixture of1%lidocaine and 0.375%bupivicaine.Before surgery,pain threshold and threshold of pain tolerance were determined;during surgery,the duration of surgery was recorded;and after surgery,QOLS（Quality Of Life Score） and PHS（Prince-Henry Score） were assessed.Results PHS in group A,group B and group C were lower than that in group D,respectively（0.20±0.41,0.17±0.38,0.10±0.31 vs 0.40±0.50,P〈0.01）,and PHS in group C was lower than those in group A and group B,respectively（both P〈0.01）.QOLS in group A,group B and group C were higher than that in group D,respectively（9.97±1.07,9.97±2.27,10.40±1.45 vs 9.73±1.41,P〈0.05,P〈0.01）,and QOLS in group C was higher than those in group A and group B,respectively（both P〈0.05）.Conclusion Acupuncture anesthesia combined with drugs has better postoperative effect than drug anesthesia.Electroacupuncture of different frequencies can significantly improve general quality of life of patients,so patients recover well after thyroid surgery.As patients in group C suffered from the slightest pain with the highest quality of life,they recovered best within the shortest time.Electroacupuncture at frequency of 2 Hz/100 Hz can better play postoperative analgesic effect.
文摘In the present study, we aimed to evaluate the intervention effect of prophylactic antibiotic use in thyroid surgery in a large hospital. From 2004 to 2012, 70 patients who underwent thyroid surgery were randomly selected each year. The quality of surgical antibiotic prophylaxis （SAP） was assessed each year in terms of antibiotic ratio, choice, duration, timing, combination, route of administration and so on. The result showed that the SAP ratio was 100% from 2004 to 2010. With our intervention, this SAP ratio was decreased to 45.7% in 2011, and it reached 2.9% in 2012. The AUD was consistently greater than 38 before 2010, while it rapidly declined to 1 in 2012. The number of DDDs per 100 operations was decreased from 431 to 3 after the intervention. The average cost of antibiotic drugs per patient was RMB 350.65 in 2010, whereas it was decreased to RMB 18.51 in 2012. The average duration of hospitalization showed no difference during the intervention. This study indicated that implementation of a multi-disciplinary protocol and clinical pharmacist interventions could improve the rational use of SAP.
文摘Objective To report a case of the implantation of thyroid hyperplastic or neoplastic tissue after endoscopic thyroidectomy and discuss this complication in aspects of prevalence, pathogenesis, protection, and therapies. Methods A systematic search of literature from the PubMed database was conducted for identifying eligible studies on implantation of thyroid hyperplastic or neoplastic cells after endoscopic thyroid surgery. Results Overall, 5 reported cases on patients suffering from endoscopic thyroid surgery with implantation of thyroid hyperplastic or neoplastic cells were included in the systematic review. Conclusions Unskilled surgeons, rough intraoperative surgical treatment, scarification or rupture of tumor, contamination of instruments, chimney effect, aerosolization of tumor cells may be associated with the implantation after endoscopic thyroidectomy. To minimize the risk of such complication, we should be more meticulous and strict the endoscopic surgery indications.
文摘Objective: to observe the therapeutic effect of dexamethasone palmitate injection on hoarseness caused by recurrent laryngeal nerve injury during thyroid surgery. Methods: 783 patients were divided into treatment group (395 cases) and control group (388 cases). After thyroidectomy, the treatment group was sprayed with dexamethasone palmitate injection 1ml:4mg, while the control group was not sprayed with any drugs. The patients' hoarseness was observed on the 1st, 3rd, 7th and 30th day after operation. The GRBAS score, voice disorder index and VHI-13 Chinese version scale were used to evaluate the patients' voice. At the same time, the occurrence of severe adverse drug reactions, upper abdominal pain and hyperglycemia within 7 days after operation, and the infection in the operation area within 30 days after operation were observed. Results: the hoarseness in the treatment group was less than that in the control group on the 1st, 3rd and 7th day after operation (p<0.05), and there was no significant difference between the two groups on the 30th day after operation (p>0.05). There was no serious adverse drug reaction in the treatment group, upper abdominal pain and hyperglycemia within 7 days after operation, and there was no significant difference between the two groups within 30 days after operation (p>0.05). Conclusion: local application of dexamethasone palmitate injection during thyroid surgery has a certain therapeutic effect on reducing hoarseness caused by recurrent laryngeal nerve injury, but it has a limited therapeutic effect on recurrent laryngeal nerve injury which has not recovered its voice 30 days after operation.
文摘Objective: to explore the application effect of neural monitor combined with nursing intervention in patients with thyroid surgery. Methods: 60 patients with thyroid surgery in our hospital from November 2019 to November 2020 were randomly divided into two groups by digital table method. The control group was given routine nursing, and the research group was given neural monitor combined nursing intervention. The scores of unhealthy emotions, Pittsburgh sleep quality score and the incidence of recurrent nerve injury were compared between the two groups before and after nursing. Results: the score of unhealthy emotions in the study group was lower than that in the control group, the Pittsburgh sleep quality score was lower than that in the control group, and the incidence of recurrent nerve injury was lower than that in the control group, P < 0.05. Conclusion: neural monitor combined with nursing intervention is effective in patients with thyroid surgery, which can reduce unhealthy emotions, improve sleep quality and reduce complications.
文摘Objectives:Tracheomalacia is defined as the weakening of the tracheal rings secondary to long-standing compression or inherent structural weakness,leading to stridor and airway compromise.The common etiological factor of tracheomalacia includes compression of the tracheal framework due to a large multinodular goiter.There are various management techniques described in the literature to manage a patient with tracheomalacia including tracheostomy,tracheal stenting,and tracheopexy.However,the evidence of tracheomalacia in the literature is conflicting.Therefore,a systematic review was conducted to estimate the incidence of tracheomalacia after thyroidectomy.Methods:The systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines.A literature search was performed on PubMed,Web of Science,Cochrane library,and Elton B.Stephens Co.cumulative index to nursing and allied health literature plus to determine the incidence of tracheomalacia among patients undergoing thyroidectomy up till October 2021.The eligibility was assessed by two independent authors.A quality assessment of individual studies was performed using the National Institute of Health quality assessment tool.Outcomes were double data extracted and were analyzed using OpenMeta.Results:The online search retrieved 214 papers,out of which 17 studies were included that fulfilled the eligibility criteria.The number of patients included in the systematic review who underwent thyroidectomy was 1108.The mean age was 55.8±7.7 years,ranging from 48 to 75 years.Tracheomalacia was reported in 146 patients(1.4%).Sternotomy was performed in 102 patients to approach the goiters with retrosternal extension.The most common intervention to manage tracheomalacia was tracheostomy or prolonged intubation.Conclusions:Tracheomalacia is a rare complication.In cases where tracheomalacia is encountered,common methods of management include tracheostomy or prolonged endotracheal intubation.Prospective,long-term studies are required to accurately assess its true incidence and associated factors.
文摘Objective Robot-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.
文摘Objective:To evaluate the effectiveness and safety of electroacupuncture in conjunction with additional medications in providing analgesia and stabilizing hemodynamic parameters during total thyroidectomy.Methods:This randomized controlled trial included 100 patients who underwent a total thyroidectomy between October 2022 and October 2023 at the Vietnam National Hospital of Acupuncture.The patients were randomized into two groups.The electroacupuncture analgesia(EA)group received EA stimulation at five acupuncture points:Hegu(LI 4),Neiguan(PC 6),Shuitu(ST 10),Quepen(ST 12),and Yifeng(SJ 17),while the control group received a bilateral superficial cervical plexus block.Primary outcomes included the level of analgesia and perioperative vital signs in both groups.Additionally,pain thresholds and serum b-endorphin levels were measured before and after electroacupuncture in the EA group.Results:Complete analgesia(Level A)was attained in 86%and 76%of the patients in the EA and control groups,respectively,with no significant difference between the two groups(P=1.00).In the EA group,the mean pain threshold after receiving EA doubled(648.7(77.4)g/s vs.305.3(45.3)g/s,P<.001),and the mean serum b-endorphin level increased by approximately 13.5 pg/mL(P<.001).All patients remained hemodynamically stable throughout the surgery.Conclusion:EA,in conjunction with additional medications that stimulate five acupuncture points,LI 4,PC 6,ST 10,ST 12,and SJ 17,was well tolerated and effectively maintained a suitable level of analgesia and hemodynamic stability during total thyroidectomy.
文摘Objective: to explore the importance and key points of negative pressure attraction nursing for incision after thyroid and mammary gland surgery. Methods: this study targeted patients with thyroid cancer, breast cancer and hyperthyroidism from August 2020 in 20 to August 2021, and the total number of cases selected was 84.After the consent of the study subjects and family members, the above 84 study subjects according to the hospitalization number, take random digital table method randomly divided into the two trial groups, including postoperative incision negative pressure attraction during the control group, postoperative incision negative pressure attraction to professional negative pressure attraction care group called the observation group. Comparative analysis of the effects of the two groups under different modes of care was conducted. Results: (1) Compared with the postoperative drainage-related indicators of the control group, the observation group had significantly lower drainage flow rate and shorter drainage time and hospitalization time under professional negative pressure attraction care. The comparison between the above drainage-related indicators was quite different, and the obtained P-value was lower than 0.05.(2) Compared with the pre-nursing pain score between the two groups, there was no significant difference, and the P-value was higher than 0.05;the pain score was decreased, but the observation group was significantly lower than the control group, and the difference between groups was large, and the P-value was lower than 0.05.(3) Compared with the two postoperative sleep quality scores, there was no significant difference, and the P-value was higher than 0.05;the two groups were lower, but the observation group was significantly lower than the control group, and the P-value was lower than 0.05.(4) The observed group had a lower incidence of postoperative complications compared with the control group, the comparison difference between groups was large, and the obtained P-value was lower than 0.05.Conclusion: during the period of incision negative pressure attraction after thyroid gland surgery, the use of professional negative pressure attraction care measures is more conducive to promote patients' rehabilitation, relieve postoperative pain, and reduce the incidence of postoperative and occurrence, which is worth actively cited in clinical time.
基金Supported by The 2024 Hospital Research Funding,No.KYQ2024008.
文摘Hypoparathyroidism is one of the main complications after total thyroidectomy,severely affecting patients’quality of life.How to effectively protect parathyroid function after surgery and reduce the incidence of hypoparathyroidism has always been a key research area in thyroid surgery.Therefore,precise localization of parathyroid glands during surgery,effective imaging,and accurate surgical resection have become hot topics of concern for thyroid surgeons.In response to this clinical phenomenon,this study compared several different imaging methods for parathyroid surgery,including nanocarbon,indocyanine green,near-infrared imaging techniques,and technetium-99m methoxyisobutylisonitrile combined with gamma probe imaging technology.The advantages and disadvantages of each method were analyzed,providing scientific recommendations for future parathyroid imaging.In recent years,some related basic and clinical research has also been conducted in thyroid surgery.This article reviewed relevant literature and provided an overview of the practical application progress of various imaging techniques in parathyroid surgery.
文摘BACKGROUND Thyroglobulin(Tg)is one of the markers of thyroid cancer,and its concentration may be elevated in patients with malignant thyroid tumors.Thyroid-stimulating hormone(TSH)is secreted by the pituitary gland,which has a significant impact on thyroid gland function.Excessively high or low TSH levels may be associated with an increased risk of thyroid cancer.Thus,in-depth studies on the association of serum Tg and TSH levels with thyroid cancer risk in patients with thyroid nodules are warranted.This can help determine whether Tg and TSH levels can predict the degree of malignancy of thyroid nodules,which can in turn guide doctors in making accurate diagnoses and treatment decisions.Furthermore,such studies can provide more accurate diagnostic methods for thyroid nodules and help patients become aware of the presence of thyroid cancer as early as possible,thereby improving the success rate of treatment and prognosis.AIM To investigate the association of serum Tg and TSH levels with the risk of thyroid cancer in patients undergoing thyroid nodule surgery.METHODS The clinical data and laboratory examination results of 130 patients who underwent thyroid nodule surgery were retrospectively analyzed.Furthermore,their preoperative serum Tg and TSH levels were recorded.Histopathological examination conducted during follow-up revealed the presence of thyroid cancer.Correlation analysis were used to analyze the association of Tg and TSH levels with the risk of thyroid cancer.RESULTS Of the 130 patients,60 were diagnosed with thyroid cancer.Statistical analysis revealed a significant positive correlation between serum Tg levels and the risk of thyroid cancer(P<0.05).This suggests that high serum Tg levels are associated with an increased risk of thyroid cancer.However,no significant correlation was observed between serum TSH levels and the risk of thyroid cancer(P>0.05).CONCLUSION In patients who underwent thyroid nodule surgery,serum Tg levels exhibited a significant correlation with the risk of thyroid cancer but serum TSH levels did not.These findings suggest that serum Tg can serve as an important biomarker for assessing the risk of thyroid cancer in these patients.
文摘The purpose of this study was to study the frequency of premature division of the inferior laryngeal nerve and its consequences in thyroid surgery. Methodology: We realized a forward-looking and retrospective study from January, 1979 till December, 2017 in the service of surgery B to the University hospital of the Point G of Bamako and in the service of ENT and cervico-facial surgery of the CHU “mother-child”, the Luxembourg of Bamako (Mali). All the patients operated in both services for mild goiters were included. Cancers and other thyroid pathologies were not included. The diagnosis of mild goiter was paused by the histological examination realized on all the surgical specimens. Results: On 2109 dissections of the lower laryngeal nerve realized during the surgical operations on the thyroid 95.1% of the cases, the nerve had a single branch;in 4.1% of the cases, the nerve had two branches;and in 0.8% of the cases, the nerve had more than 2 branches. Conclusion: The complications of the thyroid surgery in touch with the hurts of the lower laryngeal nerve are known. However, our study shows that these do not seem to be influenced by the premature division of the lower laryngeal nerve.
文摘Objectives:Thyroidectomy is among the most commonly performed head and neck surgeries,however,limited existing information is available on topics of interest and concern to patients.Study Design:Observational.Setting:Online.Methods:A search engine optimization tool was utilized to extract metadata on Google‐suggested questions that“People Also Ask”(PAA)pertaining to“thyroidectomy”and“thyroid surgery.”These questions were categorized by Rothwell criteria and topics of interest.The Journal of the American Medical Association(JAMA)benchmark criteria enabled quality assessment.Results:A total of 250 PAA questions were analyzed.Future‐oriented PAA questions describing what to expect during and after the surgery on topics such as postoperative management,risks or complications of surgery,and technical details were significantly less popular among the“thyroid surgery”group(P<0.001,P=0.005,and P<0.001,respectively).PAA questions about scarring and hypocalcemia were nearly threefold more popular than those related to pain(335 and 319 vs.113 combined search engine response page count,respectively).The overall JAMA quality score remained low(2.50±1.07),despite an increasing number of patients searching for“thyroidectomy”(r(77)=0.30,P=0.007).Conclusions:Patients searching for the nonspecific term“thyroid surgery”received a curated collection of PAA questions that were significantly less likely to educate them on what to expect during and after surgery,as compared to patients with higher health literacy who search with the term“thyroidectomy.”This suggests that the content of PAA questions differs based on the presumed health literacy of the internet user.
文摘Background:Transoral vestibular approach thyroidectomy using robotic system has advantages with articulating instrumentation.Transoral robotic thyroidectomy(TORT)can be done either using just two robot arms for instruments and an extra one for the endoscopic camera,or using three robot arms for instruments(third arm through axila)and an additional arm for the camera.Pros of additional axillary arm for TORT:The 4th arm through an additional axillary port is mainly responsible for a counter-traction of strap muscles and thyroid tissue.The additional axillary port tract is also an excellent passage for the specimen removal with lower risk of disruption or fragmentation.Ultimately,these merits from the additional axillary arm allows TORT to be performed safely in a wide range of patient groups.Cons of additional axillary arm for TORT:One of the issue with the additional axillary arm in TORT is that it leaves a cutaneous scar.Another issue to consider is the cost.In some places,robotic surgery operation fee varies with the number of arms used during the operation.Retraction of strap muscles through subcutaneous stitches applied after establishing the working space may make up for the lack of counter-traction.Conclusion:TORT can be done safely with or without the transaxillary arm and surgeon may consider pros and cons based on multiple factors.
文摘Background： lntraoperative neuromonitoring （IONM） of the recunent laryngeal nerve （RLN） has been widely applied during thyroid surgery. However, the sale range of stimulation intensity for IONM remains undetermined, Methods： Total thyroidectomies were performed on twenty dogs, and their RLNs were stimulated with a current of 5 20 mA （step-wise in 5 mA increments） for 1 min. The evoked electromyography （EMG） of vocal muscles before and after supramaximal stimulation were recorded and compared. Acute microstructural morphological changes in the RLNs were observed immediately postoperatively under an electron microscope. Results： The average stimulating threshold for RLNs stimulated with 15 mA and 20 mA showed no significant changes compared to the unstimulated RLNs （15 mA group： 0.320 ± 0.123 mA vs. 0.315 ±0.097 mA, P =0.847; 20 mA group： 0.305 ± 0.101 mA vs. 0.300 ＋ 0.103 mA, P = 0.758）. Similar outcomes were shown in average evoked EMG amplitude （15 mA group： 1,026 ± 268 p.V xs. 1,021 ± 273 p.V, P = 0.834; 20 mA group： 1,162 ± 275 μV vs. 1,200 ± 258μV, P = 0.148）. However, obvious acute microstructural morphological changes were observed in the nerves that were stimulated with 20 mA. Conclusions： A stimulation intensity less than 15 mA might be safe for IONM of the RLN.
