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You searched for subject:(Subtotal thyroidectomy). Showing records 1 – 3 of 3 total matches.

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Freie Universität Berlin

1. Leichsering, Maria-Cristina. is it reasonable to leave a dorsal remnant?.

Degree: 2013, Freie Universität Berlin

Thyroid surgery is the most frequent endocrine operation performed by general and visceral surgeons. The incidence of nodular goiter in Germany, lies, between 15-50%. Subtotal thyroid resection used to be the preferred operation until some years ago in the treatment of multinodular goiter. The “AWMF”guidelines of 1998 suggest to leave normal thyroid tissue and recommend therefore the subtotal thyroid resection. In the last years total or near total thyroidectomy has emerged increasingly as a surgical option in the therapy of multinodular goiter if both lobes are affected and has almost replaced subtotal thyroid resection worldwide. The updated “AWMF”-guidelines of 2010 recommend a total or near total thyroidectomy for multinodular goiter of both thyroid lobes, operations leaving a remnant have to be justified. Both “AWMF”-guidelines do not recommend where to leave a remnant if a subtotal thyroid resection is performed. Leaving a superior pole remnant or a dorsal remnant is described as an equal possibility. At the Vivantes Klinikum im Friedrichshain, Berlin, Germany, the dorsal part of the thyroid will always be resected, while there will be a remnant left at the upper pole provided there are no nodules detected by ultrasound preoperative and/or during the operation. The remnant tissue was left at the superior pole in the first place to reduce complications in redo surgery. Presuming that in redo surgery there is no more need to operate close to the recurrent laryngeal nerves and parathyroid glands in an anatomically altered scarred tissue. The aim of this study is to evaluate the histological affection of the dorsal part of the thyroid gland (thyroid base) in nodular goiter, even if it is not detected preoperatively. Our hypothesis is that in > 80 % there are nodules found in the thyroid base in nodular goiter. The secondary endpoint is to evaluate the equivalence between preoperative sonographic finding of nodules in the thyroid base and postoperative histological finding. This prospective study included 171 consecutive patients undergoing surgical therapy for benign nodular goiter between October 2006 and December 2007. All patients underwent preoperative sonography with documentation of existing or lack of nodules in the thyroid base. During surgery the freshly resected specimen was marked with inc at the thyroid base. Postoperatively followed a histological examination for nodules in the ink marked area. 341 thyorid lobes were evaluated sonographical and 287 thyroid lobes were evaluated histological. Due to deficient data acquisition 44 thyroid lobes were taken out of the sonographical and 81 of the histological evaluation. Sonographicaly 77,1 % and histological 92,2 % nodules were detected in the thyroid base. The McNemar test revealed no significant accordance between sonography and histology concerning the thyroid base (p>0,05). ROC analysis showed no predictive value for sonography concerning the thyroid base (AUC = 0,54). The rate of transient hypoparathyroidism was 17,6 % and of a permanent… Advisors/Committee Members: w (gender), Prof. Dr. med. T. Steinmüller (firstReferee), Priv.-Doz. Dr. med. R. Pfitzmann (furtherReferee), Prof. Dr. med. M. Pross (furtherReferee).

Subjects/Keywords: thyroid; thyroidectomy; subtotal resection; dorsal remnant; 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Leichsering, M. (2013). is it reasonable to leave a dorsal remnant?. (Thesis). Freie Universität Berlin. Retrieved from http://dx.doi.org/10.17169/refubium-13918

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Leichsering, Maria-Cristina. “is it reasonable to leave a dorsal remnant?.” 2013. Thesis, Freie Universität Berlin. Accessed December 12, 2019. http://dx.doi.org/10.17169/refubium-13918.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Leichsering, Maria-Cristina. “is it reasonable to leave a dorsal remnant?.” 2013. Web. 12 Dec 2019.

Vancouver:

Leichsering M. is it reasonable to leave a dorsal remnant?. [Internet] [Thesis]. Freie Universität Berlin; 2013. [cited 2019 Dec 12]. Available from: http://dx.doi.org/10.17169/refubium-13918.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Leichsering M. is it reasonable to leave a dorsal remnant?. [Thesis]. Freie Universität Berlin; 2013. Available from: http://dx.doi.org/10.17169/refubium-13918

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation


Freie Universität Berlin

2. Klötzler, André. long-term follow-up of a prospective randomized study.

Degree: 2014, Freie Universität Berlin

Background: Despite adequate iodine intake in Germany, there is still an endemic occurrence of benign euthyroid multinodular goiter (MNG). The radicality of surgical therapy has increased in recent years due to the risk of recurrence, but also the complication rate. The aim of this prospective randomized study was to compare the hemithyroidectomy with contralateral subtotal resection (Dunhill operation) and the bilateral subtotal thyroidectomy (BSC) in terms of complication and recurrence rates. Materials and Methods: Between 09/1994 and 06/1998 200 patients with MNG were randomized to the group DO (n = 100) or the STR group (n = 100) and were operated in the surgical clinic. One year and 10 years postoperatively, the patients were examined. The follow-up included a physical examination, an ultrasound of the thyroid and laboratory values including TSH, fT3, fT4, parathyroid hormone and Calcium. The focus was on the frequency of recurrent goiter. Furthermore, postoperative complications (hypoparathyroidism, recurrent laryngeal nerve paralysis) and the postoperative L-thyroxine dosage were investigated. Results: For the long term follow-up, data of 70 patients in the DO group and 65 patients in the STR group could be collected. Overall, one patient developed a clinically relevant recurrence (STR group) and three had a suspicious ultrasound result; one in the STR and two in the DO group. Only the patient in the STR group with an proven recurrent goiter required a re- operation (p = 0,30). The postoperative volume reduction of the residual tissue was significantly greater in the STR group compared with DO (p = 0.001). There was a correlation between postoperativ tissue volume change and postoperative regular intake of L-thyroxine and dose of L- thyroxine. The average L-thyroxine dosage was significantly lower in patients with increase of volume than in patients without volume change or volume reduction. 6% (DO) and 3% (STR) had a transient hypocalcemia (p = 0,44). In one patient of the DO group the hypocalcemia persisted. The mean PTH value in the DO group was significantly lower than in STR (p = 0.04), but mean values were in the middle normal range in both groups. Overall, 2.5% of the patients experienced transient recurrent nerve palsy and 1.5% permanent palsy. The difference between the two groups was not significant. Conclusion: Both surgical procedures can be performed in a training clinic with similar low complication rates. However, if only a small thyroid without noduls remains in situ, a very low recurrence rate is to be expected. As in recent years, the incidence fond of incidental papillary micro carcinoma has increased and as these carcinomas are treated adequately with only a hemithyroidectomy, the preference should be given to the operation of Dunhill. In addition of case of a recurrence, only one side has to be reoperated. Advisors/Committee Members: [email protected] (contact), m (gender), N.N. (firstReferee), N.N. (furtherReferee).

Subjects/Keywords: benign euthyroid multinodular goiter; Dunnhill operation; bilateral subtotal thyroidectomy; goiter recurrence; 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Klötzler, A. (2014). long-term follow-up of a prospective randomized study. (Thesis). Freie Universität Berlin. Retrieved from http://dx.doi.org/10.17169/refubium-5541

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Klötzler, André. “long-term follow-up of a prospective randomized study.” 2014. Thesis, Freie Universität Berlin. Accessed December 12, 2019. http://dx.doi.org/10.17169/refubium-5541.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Klötzler, André. “long-term follow-up of a prospective randomized study.” 2014. Web. 12 Dec 2019.

Vancouver:

Klötzler A. long-term follow-up of a prospective randomized study. [Internet] [Thesis]. Freie Universität Berlin; 2014. [cited 2019 Dec 12]. Available from: http://dx.doi.org/10.17169/refubium-5541.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Klötzler A. long-term follow-up of a prospective randomized study. [Thesis]. Freie Universität Berlin; 2014. Available from: http://dx.doi.org/10.17169/refubium-5541

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

3. Prieto Butillé, Maria Rosa. Estudio de la extensión de la tiroidectomía para el tratamiento del bocio multinodular asimétrico.

Degree: Departament de Cirurgia, 2013, Universitat Autònoma de Barcelona

Half of the patients presenting with a single benign thyroid nodule have contralateral subclinical disease. There is a controversy whether these patients should be treated with hemithyroidectomy (HMT) or with a more extensive procedure. Objective: Define the asymmetrical multinodular goiter. To assess the immediate and long-term clinical results among hemithyroidectomy and hemithyroidectomy and contralateral subtotal thyroidectomy (Dunhill operation) for the treatment of asymmetrical multinodular goiter. To identify remnant growth risk factors. Methods: Adult patients with a benign unilateral dominant nodule and contralateral nodule(s) with a diameter of less than 10 mm detected on neck ultrasonography were randomized to HMT or Dunhill (DUN). Rates of complications, remnant growth, incidental carcinoma, and reoperation were assessed. Results: A total of 118 patients (F/M: 110/8, mean age 43 years) were included and randomized: 65 to HMT and 53 to DUN. After randomization, 28 patients were excluded leaving 47 HMT and 43 DUN long-term (55 ± 35 months) evaluable patients. Mean nodule size was 38 and 6 mm for the dominant and contralateral nodules, respectively. No differences were found in operative time, accidental parathyroidectomy, parathyroid autotransplantation, or wound complications. Transient hypocalcemia was more common in DUN (30% vs 8%; P < 0.001). No permanent complications were observed. At the last follow-up visit, thyroid-stimulating hormone was similar in both groups. Remnant growth (20 vs 0%; P < 0.001), appearance of new nodules (55 vs 14%; P < 0.001), and overall reoperation rate (128 vs 1.8%, P = 0.2) were more common in HMT, mostly because of undiagnosed cancer requiring completion thyroidectomy. Thirty percent of the hemithyroidectomies developed hypothyroidism and required long-term T4 supplementation. Conclusions: The asymmetrical multinodular is the one which appears as a single nodule but has impalpable contralateral disease. The remnant growth, its number of nodules and their size al higher in hemithyroidectomy than in Dunhill operation. The prevalence of postoperative hipocalcemia is higher in patients with Dunhill operation. Up to 12.8% and 2.3% of the patients with hemithyroidectomy and Dunhill operation suffered reoperation respectively. Most of them due to a differentiated thyroid cancer. The remnant grew most in patients with hemithyroidectomy at the age of 45 or under. Advisors/Committee Members: [email protected] (authoremail), true (authoremailshow), Sitges Serra, Antonio (director), Sancho Insenser, Juan José (director), true (authorsendemail).

Subjects/Keywords: Dunhill; Subtotal thyroidectomy; Randomised clinical trial; Ciències de la Salut; 617

thyroidectomy o tiroidectomía casi total fósforo punción aspiración con aguja fina picogramos por… …subtotal unilateral Pappalardo en su estudio de asignación aleatoria y seguimiento prolongado… …enfrenta la tiroidectomía total con tiroidectomía subtotal que en su caso representa un remanente… …Tiroidectomía Total Parálisis del nervio laríngeo recurrente Temporal Permanente Temporal Subtotal… …ASIMÉTRICO Tabla 7. Prevalencia de recurrencia tras tiroidectomía subtotal tipo Dunhill por… 

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Prieto Butillé, M. R. (2013). Estudio de la extensión de la tiroidectomía para el tratamiento del bocio multinodular asimétrico. (Thesis). Universitat Autònoma de Barcelona. Retrieved from http://hdl.handle.net/10803/121590

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Prieto Butillé, Maria Rosa. “Estudio de la extensión de la tiroidectomía para el tratamiento del bocio multinodular asimétrico.” 2013. Thesis, Universitat Autònoma de Barcelona. Accessed December 12, 2019. http://hdl.handle.net/10803/121590.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Prieto Butillé, Maria Rosa. “Estudio de la extensión de la tiroidectomía para el tratamiento del bocio multinodular asimétrico.” 2013. Web. 12 Dec 2019.

Vancouver:

Prieto Butillé MR. Estudio de la extensión de la tiroidectomía para el tratamiento del bocio multinodular asimétrico. [Internet] [Thesis]. Universitat Autònoma de Barcelona; 2013. [cited 2019 Dec 12]. Available from: http://hdl.handle.net/10803/121590.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Prieto Butillé MR. Estudio de la extensión de la tiroidectomía para el tratamiento del bocio multinodular asimétrico. [Thesis]. Universitat Autònoma de Barcelona; 2013. Available from: http://hdl.handle.net/10803/121590

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

.