Medullary thyroid cancer (MRSH) has a high malignant potential in the vast majority of cases, but in some patients with MRSH is characterized by a sluggish, non-aggressive course, when patients with the presence of proven medullary carcinoma or distant metastases and / or relapse, can live without progression for a sufficiently long time. Such a course of a malignant tumor is called indolent. The article presents a clinical case of diagnosis and treatment of indolent primary MRSH in a patient with a duration of the disease of 11 years. Shows some features of the dynamics of the level of basal calcitonin and cancer-embryonic antigen (CEA), ultrasound characteristics and data of fine-needle puncture biopsy of the tumor. The phenomenon of indolent course of MRSH characterized, as a rule, by a high malignant potential, is probably due to the biological characteristics of the tumor and requires further research.
{"title":"Clinical case of indolent primary medullary cancer","authors":"S. Miroshnikov, D. B. Demin, A. Belyaeva","doi":"10.14341/serg12713","DOIUrl":"https://doi.org/10.14341/serg12713","url":null,"abstract":"Medullary thyroid cancer (MRSH) has a high malignant potential in the vast majority of cases, but in some patients with MRSH is characterized by a sluggish, non-aggressive course, when patients with the presence of proven medullary carcinoma or distant metastases and / or relapse, can live without progression for a sufficiently long time. Such a course of a malignant tumor is called indolent. The article presents a clinical case of diagnosis and treatment of indolent primary MRSH in a patient with a duration of the disease of 11 years. Shows some features of the dynamics of the level of basal calcitonin and cancer-embryonic antigen (CEA), ultrasound characteristics and data of fine-needle puncture biopsy of the tumor. The phenomenon of indolent course of MRSH characterized, as a rule, by a high malignant potential, is probably due to the biological characteristics of the tumor and requires further research.","PeriodicalId":30783,"journal":{"name":"Endokrinnaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43023930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Sleptsov, R. Chernikov, I. Sablin, A. Pushkaruk, N. Timofeeva
BACKGROUND: Surgeons from all over the world make considerable efforts to reduce thyroid intraoperative complications such as recurrent laryngeal nerves trauma and parathyroid vascular supply damage.AIM: The aim of the study was improving thyroidectomy technique to reduce the rate of postoperative complications.MATERIALS AND METHODS: Inclusion criteria were primary thyroid operation in cases of papillary or medullary cancer, follicular tumours (Bethesda IV) and Grave’s disease. Thyroid volume ranged from 12–70 ml. Tension-free technique of thyroidectomy (TFT) was suggested by the authors of this study. Key points of TFT are the following: the first step is the complete dissection of Berry ligament fibers and terminal branches of lower thyroid arteries and vein. There is only lateral traction while medial traction is not applied at all. Mobilization of the upper parathyroid gland is performed at the medial thyroid surface. Thyroid lobe is extracted out of its bed beginning with the lower pole only after complete dissection of Berry’s ligament, vessels and parathyroid glands. The last step of the operation is the dissection of the upper pole thyroid vessels. The mobilized lobe is easily withdrawn downwards, that leads to space increase between external branch of the superior laryngeal nerve and the upper pole of the lobe. Transient and continuous neuromonitoring as well as optical magnification and headlamps were used during operations. Vocal cords function was controlled before and after surgery (on the first day) by means of ultrasound or endoscopic laryngoscopy. Ionized calcium and parathyroid hormone levels were checked in cases of total thyroidectomy group on the day of surgery, on the 1st and 14th postoperative days.RESULTS: 77 consecutive patients were included into the study (continuous sampling of patients). 33 hemithyroidectomies, 13 hemithyroidectomies with central ipsilateral neck dissection, 21 thyroidectomies, 8 thyroidectomies with central neck dissection, 2 thyroidectomies with central and lateral neck dissection were performed by the same surgeon. All the operations were performed by tension-free technique (TFT). There were no cases of loss of signal from the recurrent laryngeal nerves function during all the operations. One case of postoperative transient hypoparathyroidism finished with normalization of parathyroid hormone and calcium levels in 2 weeks after the operation.CONCLUSION: initial experience in TFT allows to recommend this procedure for further practicing and examination.
{"title":"Tension-free thyroidectomy — results of the initial 77 operations","authors":"I. Sleptsov, R. Chernikov, I. Sablin, A. Pushkaruk, N. Timofeeva","doi":"10.14341/serg12718","DOIUrl":"https://doi.org/10.14341/serg12718","url":null,"abstract":"BACKGROUND: Surgeons from all over the world make considerable efforts to reduce thyroid intraoperative complications such as recurrent laryngeal nerves trauma and parathyroid vascular supply damage.AIM: The aim of the study was improving thyroidectomy technique to reduce the rate of postoperative complications.MATERIALS AND METHODS: Inclusion criteria were primary thyroid operation in cases of papillary or medullary cancer, follicular tumours (Bethesda IV) and Grave’s disease. Thyroid volume ranged from 12–70 ml. Tension-free technique of thyroidectomy (TFT) was suggested by the authors of this study. Key points of TFT are the following: the first step is the complete dissection of Berry ligament fibers and terminal branches of lower thyroid arteries and vein. There is only lateral traction while medial traction is not applied at all. Mobilization of the upper parathyroid gland is performed at the medial thyroid surface. Thyroid lobe is extracted out of its bed beginning with the lower pole only after complete dissection of Berry’s ligament, vessels and parathyroid glands. The last step of the operation is the dissection of the upper pole thyroid vessels. The mobilized lobe is easily withdrawn downwards, that leads to space increase between external branch of the superior laryngeal nerve and the upper pole of the lobe. Transient and continuous neuromonitoring as well as optical magnification and headlamps were used during operations. Vocal cords function was controlled before and after surgery (on the first day) by means of ultrasound or endoscopic laryngoscopy. Ionized calcium and parathyroid hormone levels were checked in cases of total thyroidectomy group on the day of surgery, on the 1st and 14th postoperative days.RESULTS: 77 consecutive patients were included into the study (continuous sampling of patients). 33 hemithyroidectomies, 13 hemithyroidectomies with central ipsilateral neck dissection, 21 thyroidectomies, 8 thyroidectomies with central neck dissection, 2 thyroidectomies with central and lateral neck dissection were performed by the same surgeon. All the operations were performed by tension-free technique (TFT). There were no cases of loss of signal from the recurrent laryngeal nerves function during all the operations. One case of postoperative transient hypoparathyroidism finished with normalization of parathyroid hormone and calcium levels in 2 weeks after the operation.CONCLUSION: initial experience in TFT allows to recommend this procedure for further practicing and examination.","PeriodicalId":30783,"journal":{"name":"Endokrinnaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41303424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-08DOI: 10.1201/9780429197338-30
R. Parameswaran, Sheeja Sainulabdeen
{"title":"Anatomy and Pathology of the Parathyroid Gland","authors":"R. Parameswaran, Sheeja Sainulabdeen","doi":"10.1201/9780429197338-30","DOIUrl":"https://doi.org/10.1201/9780429197338-30","url":null,"abstract":"","PeriodicalId":30783,"journal":{"name":"Endokrinnaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41863670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MA R'tr Identification of a thyroid nodule initiates a series of investigations to establish a specific diagnosis, which will then allow for appropriate therapy. Blood tests are essential to establish thyroid function and to add support to the clinical diagnosis of thyroiditis. Imaging procedures are rarely necessary. Fine needle biopsy offers an effective tool to determine the cause of the nodule. Therapy will include either observation, thyroxine suppression, or surgery (which should be used sparingly).
{"title":"Approach to Thyroid Nodules","authors":"C. Chng","doi":"10.1201/9780429197338-9","DOIUrl":"https://doi.org/10.1201/9780429197338-9","url":null,"abstract":"MA R'tr Identification of a thyroid nodule initiates a series of investigations to establish a specific diagnosis, which will then allow for appropriate therapy. Blood tests are essential to establish thyroid function and to add support to the clinical diagnosis of thyroiditis. Imaging procedures are rarely necessary. Fine needle biopsy offers an effective tool to determine the cause of the nodule. Therapy will include either observation, thyroxine suppression, or surgery (which should be used sparingly).","PeriodicalId":30783,"journal":{"name":"Endokrinnaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42301676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-08DOI: 10.1201/9780429197338-19
M. Ozdemir, Ö. Makay
{"title":"Rare Tumors of the Thyroid","authors":"M. Ozdemir, Ö. Makay","doi":"10.1201/9780429197338-19","DOIUrl":"https://doi.org/10.1201/9780429197338-19","url":null,"abstract":"","PeriodicalId":30783,"journal":{"name":"Endokrinnaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44411161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-08DOI: 10.1201/9780429197338-23
L. Enny, Faraz Ahmad, Kulranjan Singh, Anand Kumar Mishra
Objective: The aim of this study was to determine if bilateral inferior thyroid artery (ITA) ligation is a causal factor for the occurrence of postoperative hypocalcaemia after subtotal thyroidectomy. Study design : Quasi experimental trial. Place and duration of study : One year study from Jan 2005 to Dec 2005 conducted at surgical department of Rawalpindi General Hospital (UNIT–I). Patients and Methods : One hundred patients were included in the study who underwent subtotal thyroidectomy with and without truncal ligation of inferior thyroid artery and were prospectively analyzed comparing postoperative and late serum calcium levels. Result: A significant incidence of postoperative hypocalcaemia occurred: more in Group A (48%) as compared to Group B (22%). This difference was statistically significant shown by the P value < 0.5 on the 1st postoperative day in patients with ligation of inferior thyroid artery. Conclusion : The ligation of the ITA tends to produce hypocalcaemia in patients undergoing subtotal Thyroidectomy.
{"title":"Postthyroidectomy Hypocalcemia","authors":"L. Enny, Faraz Ahmad, Kulranjan Singh, Anand Kumar Mishra","doi":"10.1201/9780429197338-23","DOIUrl":"https://doi.org/10.1201/9780429197338-23","url":null,"abstract":"Objective: The aim of this study was to determine if bilateral inferior thyroid artery (ITA) ligation is a causal factor for the occurrence of postoperative hypocalcaemia after subtotal thyroidectomy. Study design : Quasi experimental trial. Place and duration of study : One year study from Jan 2005 to Dec 2005 conducted at surgical department of Rawalpindi General Hospital (UNIT–I). Patients and Methods : One hundred patients were included in the study who underwent subtotal thyroidectomy with and without truncal ligation of inferior thyroid artery and were prospectively analyzed comparing postoperative and late serum calcium levels. Result: A significant incidence of postoperative hypocalcaemia occurred: more in Group A (48%) as compared to Group B (22%). This difference was statistically significant shown by the P value < 0.5 on the 1st postoperative day in patients with ligation of inferior thyroid artery. Conclusion : The ligation of the ITA tends to produce hypocalcaemia in patients undergoing subtotal Thyroidectomy.","PeriodicalId":30783,"journal":{"name":"Endokrinnaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48381421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-08DOI: 10.1201/9780429197338-53
Divya Srivastava, B. Naithani
{"title":"Anesthetic Management for Pheochromocytoma","authors":"Divya Srivastava, B. Naithani","doi":"10.1201/9780429197338-53","DOIUrl":"https://doi.org/10.1201/9780429197338-53","url":null,"abstract":"","PeriodicalId":30783,"journal":{"name":"Endokrinnaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46164514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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