Dataset Information

Patient, thyroid, and surgeon related factors that make thyroidectomy difficult-cohort study.

ABSTRACT:

Introduction

When thyroidectomy is performed under optimal conditions within a milieu of sound anatomical and physiological knowledge combined with meticulous surgical skills, complications are minimal. However, thyroidectomy can be difficult, and its complications can be life-threatening. The factors that predict difficult thyroidectomy can be patient-, thyroid-, or surgeon-related, and we aimed to study these three factors. .

Materials and methods

This prospective study was performed in a tertiary care center between September 2016 and March 2017. We developed and validated modified thyroidectomy difficulty scale (TDS), with 11 items. Preoperatively, height, weight, neck length, and other parameters were recorded. Postoperatively, the modified TDS form was filled out by the surgeon and assistant, blinded to each other's responses. The minimum score was 19 and maximum was 54. The surgeon's baseline pulse rate was monitored throughout the procedure using a pulse oximeter probe that was On-The-Go (OTG) compatible. The probe was placed over the ear lobule/pinna of the surgeon and connected to an Android phone that was comfortably placed in the surgeon's pocket inside the gown. An application USB SPO₂, was used in recording the pulse rate.

Results

A total of 52 patients undergoing hemi- or total thyroidectomy were included in this study. All had benign cytology on fine needle aspiration cytology (colloid, 71.42%). A total of 104 modified TDS questionnaires filled by the operating surgeon and assistant were analyzed. The pulse rate of the operating surgeon, as measured by the novel pulse oximeter, was recorded in 52 surgeries. The minimum score was 20, maximum score was 35.50, and mean score was 26.85 ± 2.80. There was an interobserver agreement in most domains of the modified TDS except mobility. The surgeon was found to have the maximum heart rate when performing recurrent laryngeal nerve (RLN) dissection in 38 patients (73.07%).

Discussion

We found that majority of the trainees found thyroidectomy to be a vigorously intense activity. Thyroidectomy is a demanding surgery, which requires meticulous identification and dissection of the RLN and parathyroid glands for optimum outcome.

SUBMITTER: Bothra S

PROVIDER: S-EPMC6909039 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Patient, thyroid, and surgeon related factors that make thyroidectomy difficult-cohort study.

Bothra Sapana S Sabaretnam Mayilvaganan M Kannujia Asish A Chand Gyan G Agarwal Gaurav G Mishra S K SK Agarwal Amit A

Annals of medicine and surgery (2012) 20191123

<h4>Introduction</h4>When thyroidectomy is performed under optimal conditions within a milieu of sound anatomical and physiological knowledge combined with meticulous surgical skills, complications are minimal. However, thyroidectomy can be difficult, and its complications can be life-threatening. The factors that predict difficult thyroidectomy can be patient-, thyroid-, or surgeon-related, and we aimed to study these three factors. .<h4>Materials and methods</h4>This prospective study was perf ...[more]

PMID: 31871677

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Project description:While the thyroid has the capacity to grow in response to a stimulus that perturbs the pituitary-thyroid axis, cells involved in this process have not been well characterized. In this study, partial thyroidectomy was used to produce regeneration. Histological and gene profiling analyses were carried out using normal mouse thyroid as well as those after partial thyroidectomy. In the central area of the right or left normal thyroid lobe, a proliferative center was found with the occasional presence of micro-follicles, where BrdU-positive and/or C cells were mainly localized. Two weeks after partial thyroidectomy, the number of BrdU-positive cells and cells with clear or faintly eosionphilic cytoplasm, markedly increased in the central area of the thyroid lobe and the overlapping area close to the cutting edge. Clear-looking cells had scant cytoplasmic components as determined by electron microscopy; some retained characteristic features of C cells such as the presence of neuroendocrine granules while others retained follicular cell specific features such as those directly facing a lumen with microvilli at the apical side of the cell. Some of the clear-looking cells were BrdU-positive and expressed FOXA2, the definitive endoderm lineage marker. Microarray analysis further revealed that partial thyroidectomy affected the expression pattern of genes involved in cellular and/or metabolic process and their regulation categorized as Endocrine System Disorders and Embryonic Development, by Pathway analysis. These results suggest that cells previously C cells and/or follicular cells may be altered after partial thyroidectomy to become immature cells that participate in the repair and/or regeneration of the thyroid, a process similar to embryonic thyroid development. Total RNAs used for microarray analysis were prepared from laser capture microdissected mouse thyroids of the central (C) and peripheral (P) areas before (N: normal) and after (D: dissected) partial thyroidectomy. The RNAs obtained were first amplified, which were then subjected to hybridization using 5 NC (central area of the right or left lobe of normal thyroid), 3 NP (peripheral area of the right or left lobe of normal thyroid), 5DC (central area of the right or left lobe of dissected thyroid), 5 DP (peripheral area of the right or left lobe of dissected thyroid), and universal mouse RNAs as a reference. The 4-way analysis was carried out: NC vs NP vs DC vs DP.

Dataset Information

Patient, thyroid, and surgeon related factors that make thyroidectomy difficult-cohort study.

Introduction

Materials and methods

Results

Discussion

Publications

Patient, thyroid, and surgeon related factors that make thyroidectomy difficult-cohort study.

Similar Datasets

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