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2.
Rev. Col. Bras. Cir ; 48: e20202557, 2021. tab, graf
Article in English | LILACS | ID: biblio-1155373

ABSTRACT

ABSTRACT The thyroidectomy is the most frequently executed procedure in head and neck surgery. Since its first description by Kocher, the transverse cervical incision has been the main access to the thyroid site, as it provides broad exposure of the central neck compartment. Despite the meticulous suture of the incision, the development of a scar with variable dimensions is unavoidable and, hence, some patients might not agree to the approach, due to this consequence. The transoral endoscopic thyroidectomy vestibular access (TOETVA) gains importance as an alternative to the traditional surgery, since it avoids the formation of visible scars. The objective of this study is to develop a systematic review on the currently available literature to evaluate possible complications related to the TOETVA. The systematic review was based on the databases of Medline, Cochrane library, Embase and Scielo/Lilacs, resulting in the selection of six studies, which were compared in regard of the type of study duration of the study and identified complications. Our study showed that TOETVA is related to complications similar to the ones identified in the conventional approach, such as hematoma, seroma, recurrent laryngeal nerve injury, hypoparathyroidism, surgical site infection. The TOETVA was associated to a higher risk of thermic injury of the skin and mentual nerve paresthesia. Moreover, it was possible to conclude that TOETVA is a safe procedure for well selected patients, with favorable conditions and concerned about the aesthetic outcome. The risk of complications of the procedure should always be explained to those patients.


RESUMO A tireoidectomia é o procedimento cirúrgico mais frequentemente realizado na cirurgia de cabeça e pescoço. Desde sua descrição por Kocher, a incisão cervical transversa constitui o principal acesso à loja tireoideana e permite ampla exposição à região central do pescoço. Apesar do fechamento meticuloso da incisão, uma cicatriz de dimensões variáveis é inevitável, e certos pacientes podem discordar de tal abordagem. A tireoidectomia vestibular endoscópica transoral (TOETVA) ganha importância como alternativa à cirurgia tradicional, pois evita a formação de cicatrizes visíveis. O objetivo de estudo é realizar uma revisão sistemática da literatura das possíveis complicações da TOETVA. Foi realizada revisão sistemática da literatura nas bases de dados Medline, The Cochrane Library, Embase e SciElo/Lilacs, sendo selecionados seis artigos e tabulados os dados de tipo de estudo, período do estudo e complicações apresentadas. O estudo mostra que a TOETVA apresenta complicações semelhantes à técnica convencional, como hematoma, seroma, lesão de nervo laríngeo recorrente, hipoparatireoidismo, além de infecção de sítio cirúrgico, com maior risco de lesão térmica da pele e parestesia por lesão do nervo mentual. Em adição, foi possível concluir que a TOETVA é uma técnica segura para pacientes bem selecionados, com condições favoráveis e com especial preocupação com resultados estéticos, devendo sempre ser orientados sobre possíveis complicações.


Subject(s)
Humans , Thyroid Gland/surgery , Thyroidectomy/methods , Natural Orifice Endoscopic Surgery/adverse effects , Hypoparathyroidism/surgery , Postoperative Complications , Thyroidectomy/adverse effects , Hematoma
3.
Rev. bras. anestesiol ; 70(6): 595-604, Nov.-Dec. 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1155768

ABSTRACT

Abstract Background and objectives: In this study, we aimed to investigate the predictive value of different airway assessment tools, including parts of the Simplified Predictive Intubation Difficulty Score (SPIDS), the SPIDS itself and the Thyromental Height Test (TMHT), in intubations defined as difficult by the Intubation Difficulty Score (IDS) in a group of patients who have head and neck pathologies. Methods: One hundred fifty-three patients who underwent head and neck surgeries were included in the study. The Modified Mallampati Test (MMT) result, Thyromental Distance (TMD), Ratio of the Height/Thyromental Distance (RHTMD), TMHT, maximum range of head and neck motion and mouth opening were measured. The SPIDSs were calculated, and the IDSs were determined. Results: A total of 25.4% of the patients had difficult intubations. SPIDS scores >10 had 86.27% sensitivity, 71.57% specificity and 91.2% Negative Predictive Value (NPV). The results of the Receiver Operating Curve (ROC) analysis for the airway screening tests and SPIDS revealed that the SPIDS had the highest area under the curve; however, it was statistically similar to other tests, except for the MMT. Conclusions: The current study demonstrates the practical use of the SPIDS in predicting intubation difficulty in patients with head and neck pathologies. The performance of the SPIDS in predicting airway difficulty was found to be as efficient as those of the other tests evaluated in this study. The SPIDS may be considered a comprehensive, detailed tool for predicting airway difficulty.


Resumo Justificativa e objetivos: Neste estudo, avaliamos o valor preditivo de diferentes ferramentas de avaliação das vias aéreas, incluindo componentes do Escore Simplificado Preditivo de Intubação Difícil (ESPID), o próprio ESPID e a Medida da Altura Tireomentoniana (MATM), em intubações definidas como difícies pelo Escore de Dificuldade de Intubação (EDI) em um grupo de pacientes com patologia de cabeça e pescoço. Método: Incluímos no estudo 153 pacientes submetidos a cirurgia de cabeça e pescoço. Coletamos os resultados do Teste de Mallampati Modificado (TMM), Distância Tireomentoniana (DTM), Razão Altura/Distância Tireomentoniana (RADTM), MATM, amplitude máxima de movimentação da cabeça e pescoço e da abertura da boca. Os ESPIDs foram calculados e os EDIs, determinados. Resultados: Observamos intubação difícil em 25,4% dos pacientes. Os escores de ESPID > 10 tiveram sensibilidade de 86,27%, especificidade de 71,57% e valor preditivo negativo de 91,2% (VPN). O resultado da análise da curva de operação do receptor (curva ROC) para os testes de avaliação das vias aéreas e ESPID mostrou que o ESPID tinha a maior área sob a curva; no entanto, foi estatisticamente semelhante a outros testes, exceto para o TMM. Conclusões: O presente estudo demonstra o uso prático do ESPID na previsão da dificuldade de intubação em pacientes com patologia de cabeça e pescoço. O desempenho do ESPID na predição de via aérea difícil mostrou-se tão eficiente quanto os demais testes avaliados neste estudo. O ESPID pode ser considerado ferramenta abrangente e detalhada para prever via aérea difícil.


Subject(s)
Humans , Adult , Aged , Aged, 80 and over , Young Adult , Intubation, Intratracheal/methods , Neck/surgery , Neck Dissection/statistics & numerical data , Thyroid Gland/surgery , Tongue Neoplasms/surgery , Nasopharyngeal Neoplasms , Predictive Value of Tests , Prospective Studies , ROC Curve , Range of Motion, Articular , Sensitivity and Specificity , Outcome Assessment, Health Care , Mandibular Advancement , Head and Neck Neoplasms/surgery , Intubation, Intratracheal/instrumentation , Laryngectomy/statistics & numerical data , Maxillofacial Injuries/surgery , Middle Aged , Mouth/physiology , Neck/anatomy & histology
4.
Int. j. morphol ; 38(4): 1128-1135, Aug. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1124905

ABSTRACT

El estudio de las venas tiroideas no ha recibido una investigación tan exhaustiva como lo tuvieron las arterias tiroideas y los nervios laríngeos en relación a la cirugía tiroidea.De los tres pedículos venosos de la glándula tiroides, el medio, de lejos es el menos estudiado. La vena tiroidea media es inconstante y es el primer elemento vascular de la glándula tiroides que debe ser seccionado antes de luxar el lóbulo hacia medial para evaluar sus relaciones posteriores. Su lesión puede provocar sangrado intraoperatorio dificultando secundariamente la identificación del nervio laríngeo inferior y las glándulas paratiroides, próximas a la misma. Se realizó un estudio descriptivo de corte transversal evaluando la pesencia, número, simetría y asociación de la vena tiroidea media con variables tales como edad y sexo del paciente, así como la hiperfuncionalidad de la glándula tiroides y la presencia del tubérculo de Zuckerkandl en 100 tiroidectomías totales llevadas a cabo en el Instituto Nacional del Cáncer y en el Servicio de Otorrinolaringología del Hospital Central del Instituto de Previsión Social del Paraguay. La prevalencia global de vena tiroidea media fue del 74 %. En el lóbulo derecho, la vena se presentó en el 60 %, mientras que en el lóbulo izquierdo en el 53 %. En el 38 % se encontró la vena en ambos lóbulos. En 4 pacientes se localizaron venas tiroideas medias dobles, en una de ellas fue bilateral. El mayor porcentaje de las venas tiroideas medias se originó en el tercio medio del lóbulo, el 72 % en el lado derecho y el 70% en el izquierdo. No se encontró asociación entre la presencia de la vena tiroidea media y la edad, sexo, estado de hiperfunción glandular, así como tampoco con la presencia del tubérculo de Zuckerkandl.


The study of the thyroid veins has not received an investigation as extensive as the thyroid arteries and laryngeal nerves did in relation to thyroid surgery. Of the three veins pedicles of the gland the middle is far the least studied. This vein is inconstant and is the first vascular element of the gland that must be sectioned before the medial lobe is dislocated to evaluate ist posterior relationships. His injury can cause intraoperative bleeding, making it difficult to identify the inferior laryngeal nerve and the parathyroid glands, proximal to it. A descriptive crossseccional study was carried aot evaluating the presence, number, symmetricity and association of the middle thyroid vein with variables such as age and sex of the patient, as well as the hyperfunctionality of the gland and the presence of the Zuckerkandl tubercle in 100 total thyroidectomies undergoing at the National Cancer Institute and the ENT Service of the Social Security Institute´s Central Hospital. The overall prevalence of the middle thyroid vein was 74%. In the right lobe the vein appeared in 60% while in the left lobe in 53 %. Double middle thyroid vein was found in 4 patients, in one of them it was bilateral. The highest percentage of the middle thyroid veins originated in the middle third of the lobe, 72 % on the right and 70% on the left side. No association was found between the presence of the vain and age and sex, the state of glandular hyperfunstion, as well as the presence of Zuckerkandl tubercle.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Thyroid Gland/blood supply , Veins/anatomy & histology , Veins/surgery , Thyroid Gland/surgery , Thyroidectomy , Prevalence , Cross-Sectional Studies
5.
Arch. endocrinol. metab. (Online) ; 64(4): 427-435, July-Aug. 2020. tab, graf
Article in English | LILACS | ID: biblio-1131116

ABSTRACT

ABSTRACT Objective The most vital complications of thyroidectomy are recurrent nerve damage and hypocalcaemia. We aimed to compare the tissue perfusion scores (PS) of IG fluorescence angiography (IGFA) and visual examination by the surgeon after total thyroidectomy. Subjects and methods Forty-three patients were accepted into the study. Localisation of the parathyroid gland (PG) was determined by the naked eye and scored in terms of tissue perfusion. The averages of fluorescent light intensities for each IGFA were calculated, the perfusions were scored and compared with the PS given by the surgeon. Biochemical parameters were noted. Results 37.2% of patients had autotransplanted PGs, according to their visual scores. The means of IGFA-PS for PGs scored as 0, 1 or 2 on visual inspection were 48.58 ± 4.49 [30-70], 89.65 ± 8.93 [36-144] and 158.76 ± 8.93 [70-253], respectively, which correlated with the visual PSs in a statistically significant manner (P < 0.0001). The predictive cut-off value for IGFA-PS was determined to be 70, given a visual PS of 0 (95% CI [0.72-0.85]), and this was interpreted to be a candidate cut-off point for the autotransplantation of PGs. Conclusion IGFA scoring may be considered as an operative predictor, providing objective criteria to evaluate the tissue and blood perfusion of PGs after thyroidectomy. IGFA scoring may be considered to have value in minimising postoperative permanent hypoparathyroidism in patients.


Subject(s)
Humans , Parathyroid Glands , Thyroid Gland/surgery , Postoperative Complications , Thyroidectomy , Fluorescein Angiography , Hypoparathyroidism , Indocyanine Green
6.
Rev. otorrinolaringol. cir. cabeza cuello ; 80(1): 75-78, mar. 2020. graf
Article in Spanish | LILACS | ID: biblio-1099205

ABSTRACT

Los cuerpos extraños alojados en la vía aéreodigestiva superior son un motivo de consulta frecuente para el otorrinolaringólogo. Uno de los más frecuentes son las espinas de pescado. En raras ocasiones, éstas migran hacia tejidos adyacentes y generan complicaciones importantes. Presentamos el caso de una paciente que tras la ingesta de pescado manifiesta sensación de cuerpo extraño faríngeo, odinofagia y dolor látero cervical derecho. Dada la ausencia de hallazgos a la exploración física y laringoscópica se realiza una tomografia computarizada cervical, visualizando un cuerpo extraño alojado en la glándula tiroidea. Se interviene mediante cervicotomía media, realizando la extracción de la espina sin complicaciones. El diagnóstico precoz y manejo adecuado es determinante para prevenir complicaciones en estos casos.


Foreign bodies in the aerodigestive tract are commonly confronted in otolaryngology practice. The most frequent are the fish bones. In rare cases they can move and cause numerous complications. We report the case of a patient that manifest the sensation of pharyngeal foreign body, after fish ingestion. She also referred odynophagia and right cervical pain. Physical and laryngoscopic examination were normal. A cervical CT was performed, where a foreign body lodged in the thyroid gland was visualized, median cervicotomy was done and the foreign body was extracted. Early diagnosis and adequate management are crucial to prevent complications in these cases.


Subject(s)
Humans , Female , Middle Aged , Thyroid Gland/injuries , Foreign Bodies/surgery , Foreign Bodies/diagnostic imaging , Thyroid Gland/surgery , Bone and Bones , Tomography, X-Ray Computed , Foreign-Body Migration/surgery , Foreign-Body Migration/diagnostic imaging , Seafood
7.
Rev. méd. hondur ; 87(2): 76-70, abr.-dic. 2019. ilus
Article in Spanish | LILACS, BIMENA | ID: biblio-1097735

ABSTRACT

Antecedentes: El hiperparatiroidismo primario, tercer trastorno metabólico más común a nivel mundial, provoca un aumento del calcio sérico y de la hormona paratiroidea, causado por una hiperactividad de las glándulas paratiroideas. En el 85% de los casos, se debe a un adenoma paratiroideo. Es predominantemente asintomático (>80%), pero sus manifestaciones pueden ser musculo-esqueléticas, neurológicas, psiquiátricas, renales, cardiovasculares, y gastrointestinales. Descripción del Caso Clínico: Paciente femenina de 53 años de edad, con antecedente de hipercolesterolemia familiar heterocigoto e hipertensión arterial; presenta insomnio, náuseas, pérdida de peso, mialgias, astenia, relujo gastroesofágico e irritabilidad. Ante indicación de exámenes de labo-ratorio muestra hipercalcemia leve. Se comprueba un adenoma paratiroideo derecho y nódulos tiroideos coloides benignos en lóbulo izquierdo mediante gammagrafía Tc99m MIBI, siendo sometida a su resección con posterior evolución satisfactoria. Conclusiones: Considerando la predilección asintomática del hiperparatiroidismo primario y su preferencia de presentación como adenoma, resulta indispensable su sospecha ante toda hipercalcemia. Requiere entonces una concientización amplia no solo en el ámbito médico sino también en la comunidad, ampliando esfuerzos entre el clínico, cirujano, y patólogo. Se recomienda medir el calcio y fósforo sérico de forma rutinaria en la evaluación clínica cotidiana de cada paciente para su detección...(AU)


Subject(s)
Humans , Male , Middle Aged , Parathyroid Neoplasms/complications , Thyroid Gland/surgery , Hyperparathyroidism, Primary/diagnosis , Hypercalcemia
8.
Arch. endocrinol. metab. (Online) ; 63(3): 300-305, May-June 2019. tab, graf
Article in English | LILACS | ID: biblio-1011171

ABSTRACT

ABSTRACT Objective Hürthle cell carcinomas (HCCs) of the thyroid have been recently reclassified as a separate entity due to their distinct clinical and molecular profiles. Few studies have assessed the ability of preoperative characteristics in differentiating HCCs from Hürthle cell adenomas (HCAs) due to the low prevalence of both lesions. This study aimed to compare the preoperative features of HCCs and HCAs and evaluate the diagnostic performance of ultrasound in distinguishing between both. Subjetcs and methods Retrospective study including 101 patients (52 HCCs and 49 HCAs) who underwent thyroid surgery from 2000 to 2016. Clinical, ultrasonographic, and histological data were reviewed. Diagnostic performance of suspicious sonographic features was analyzed in 51 cases (24 HCCs and 27 HCAs). Results Hürthle cell neoplasms were predominant in females. Subjects ≥ 55 years represented 58% of the cases of HCCs and 53% of those of HCAs. Carcinomas were significantly larger (p < 0.001), and a tumor size ≥ 4 cm significantly increased the risk of malignancy (odds ratio 3.67). Other clinical, cytologic, and sonographic data were similar between HCCs and HCAs. Among the HCCs, the lesions were purely solid in 54.2%, hypoechoic in 37.5%, and had coarse calcifications in 12.5%, microcalcifications in 8.3%, irregular contours in 4.2%, and a taller-than-wide shape in 16.7%. Predominantly/exclusive intranodular vascularization was observed in 52.6%. Overall, 58% of the HCCs were classified as TI-RADS 4 or 5 compared with 48% of the HCAs. TI-RADS 4 or 5 had a specificity of only 51.8% and a positive likelihood ratio of 1.21. Conclusions Apart from the lesion size, no other preoperative feature adequately distinguished HCCs from HCAs. Sonographic characteristics raising suspicion for malignancy, which are mostly present in papillary carcinomas, were infrequent in HCCs. New tools must be developed to improve preoperative diagnosis and deferral of surgery in cases of adenomas.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Thyroid Gland/diagnostic imaging , Thyroid Neoplasms/diagnostic imaging , Adenoma/diagnostic imaging , Carcinoma, Papillary, Follicular/diagnostic imaging , Ultrasonography, Doppler/methods , Thyroid Gland/surgery , Thyroid Gland/pathology , Thyroid Neoplasms/surgery , Thyroid Neoplasms/pathology , Adenoma/surgery , Adenoma/pathology , Retrospective Studies , Carcinoma, Papillary, Follicular/surgery , Carcinoma, Papillary, Follicular/pathology , Diagnosis, Differential
9.
Rev. Col. Bras. Cir ; 46(4): e2249, 2019. graf
Article in Portuguese | LILACS | ID: biblio-1020369

ABSTRACT

RESUMO Objetivo: avaliar se a projeção lateral da glândula tireoide, chamada tubérculo de Zuckerkandl (TZ), pode auxiliar o cirurgião na identificação do nervo laríngeo inferior durante a tireoidectomia convencional aberta. Métodos: estudo prospectivo de 51 pacientes submetidos à tireoidectomia, com um total de 100 lobos tireoidianos ressecados, e observação da presença ou não do TZ em dimensões suficientes para ser identificado sem magnificação de imagem, suas dimensões de base e altura, sua localização na glândula e sua relação anatômica com o nervo laríngeo inferior. Resultados: o TZ estava presente em 68 dos 100 lobos de tireoide analisados (68%). A dimensão média da base foi 6,7mm no lado direito e 7,1mm no lado esquerdo, e a altura média foi 5,7mm no lado direito e 6,1mm no lado esquerdo. Na maioria dos lobos estudados, o tubérculo tinha altura mínima de 5mm (55,9%) sem diferença significativa entre o lobo direito e esquerdo da glândula tireoide. Durante a cirurgia, 100% dos TZ identificados estavam anteriores ao nervo laríngeo inferior, imediatamente abaixo da entrada do nervo na laringe. Conclusão: o TZ é bastante frequente e em dimensões suficientes para ser usado como referência anatômica na localização intraoperatória do nervo laríngeo inferior, próximo à sua entrada na laringe, junto com as demais referências anatômicas.


ABSTRACT Objective: to evaluate whether the lateral projection of the thyroid gland, called Zuckerkandl's tubercle (ZT), can assist the surgeon in identifying the inferior laryngeal nerve during conventional open thyroidectomy. Methods: we conducted a prospective study with 51 patients submitted to thyroidectomy, with a total of 100 resected thyroid lobes, and observed the presence or absence of ZT in sufficient dimensions to be identified without image magnification, its base and height, its location in the gland, and its anatomical relationship with the inferior laryngeal nerve. Results: ZT was present in 68 of the 100 thyroid lobes analyzed (68%). The mean base was 6.7mm on the right side and 7.1mm on the left side, and the average height was 5.7mm on the right side and 6.1mm on the left side. In most of the lobes studied, the tubercle had a minimum height of 5mm (55.9%), with no significant difference between the right and left lobes of the thyroid gland. During surgery, 100% of the identified ZTs were anterior to the inferior laryngeal nerve, just below the nerve entry in the larynx. Conclusion: the ZT is a quite frequent entity and large enough to serve as an intraoperative anatomical reference for the inferior laryngeal nerve, next to its entry in the larynx, along with other anatomical references.


Subject(s)
Humans , Male , Female , Adult , Aged , Young Adult , Recurrent Laryngeal Nerve/anatomy & histology , Thyroid Gland/anatomy & histology , Thyroid Gland/surgery , Anatomic Landmarks , Thyroid Diseases/surgery , Thyroidectomy/methods , Prospective Studies , Middle Aged
11.
Rev. chil. cir ; 70(6): 557-564, dic. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-978030

ABSTRACT

Objetivo: La cirugía mayor ambulatoria (CMA) y con estancia inferior a 24 horas (overnight stay) se ha consolidado en muchas patologías aunque en cirugía tiroidea y paratiroidea resulta controvertido. El objetivo es valorar nuestros resultados en cirugía del tiroides y paratiroides en régimen de CMA durante un periodo de 6 años. Material y Métodos: Estudio observacional prospectivo de pacientes con indicación de hemitiroidectomía o paratiroidectomía enfocada en régimen CMA entre enero de 2011 y diciembre de 2016. Los pacientes cumplían criterios de CMA. En los primeros años se excluyeron los nodulos tiroideos mayores de 3 cm y los pacientes ASA III. Los pacientes ingresaron la mañana de la intervención, tras el acto quirúrgico pasaron a la Unidad de Recuperación Posquirúrgica y posteriormente a sala de hospitalización. Tras 8 h, si cumplían criterios, fueron dados de alta. Resultados: Se intervinieron 270 pacientes, la tasa de aplicabilidad global fue del 59%, la tasa de aceptabilidad global del 83,6% y el índice de sustitución del 49,2%. El índice de ingresos no deseados fue del 10,4% para la paratiroidectomía y del 17,6% en la cirugía del tiroides. Ningún paciente presentó complicaciones mayores en su domicilio. El grado de satisfacción fue alto o muy alto en el 94% de los pacientes. Conclusiones: La paratiroidectomía enfocada y la hemitiroidectomía realizada por cirujanos expertos en pacientes seleccionados, es segura y efectiva en régimen ambulatorio. Es posible mejorar el índice de sustitución ambulatorio aumentando la tasa de aplicabilidad y aceptabilidad.


Objetive: Ambulatory or overnight stay surgery have been consolidated in many different procedures. However, its use in thyroid and parathyroid surgery is still controversial. The aim of this report is to present the results of 6 years of ambulatory patients undergoing surgery of the thyroid or parathyroid glands. Material and Methods: Prospective observational study of patients who underwent hemithyroidectomy or selective parathyroidectomy in the ambulatory program from January 2011 to December 2016. All patients included met the general criteria of ambulatory surgery. During the first years nodules bigger than 3 cm and patients classified as ASA III were excluded. Patients arrive at hospital the morning of surgery. After the operation, patients pass to the post-anesthesia care unit and then to the hospitalization room. 8 hours after surgery patients are discharged home if they meet the criteria. Results: 270 patients were operated, 159 of them met the inclusion criteria. The overall applicability rate was 59%. The acceptance rate was 83.6% and the substitution index was 49.2%. The unwanted hospital admission was 10.4% for the parathyroidectomy and 17.6% for the hemithyroidectomy. Any patient presented major complications at home. The satisfaction rate was high or very high for 94% of the patients. Conclusion: Selective parathyroidectomy and hemithyroidectomy performed by experienced surgeons in selected patients can be safely and effectively carried out in ambulatory surgery (outpatient). It would be possible to improve the substitution index by increasing the application and acceptability ratios.


Subject(s)
Humans , Male , Female , Thyroidectomy/methods , Parathyroidectomy/methods , Hyperparathyroidism, Primary/surgery , Ambulatory Surgical Procedures/adverse effects , Goiter, Nodular/surgery , Parathyroid Glands/surgery , Thyroid Gland/surgery , Prospective Studies , Treatment Outcome , Patient Satisfaction
12.
Bol. méd. postgrado ; 34(2): 30-33, Jul-Dic. 2018.
Article in Spanish | LILACS, LIVECS | ID: biblio-1120813

ABSTRACT

Con el objetivo de describir las complicaciones postoperatorias en pacientes sometidos a tiroidectomía sin drenaje que asistieron al Servicio de Cirugía General del Hospital Central Universitario Dr. Antonio María Pineda durante el lapso enero 2017-enero 2018, se realizó un estudio descriptivo transversal evaluando 142 historias donde los pacientes se caracterizaron por un promedio de edad de 50,23 ± 12,71 años, con predominio del sexo femenino (88%) y estado nutricional normal (58,45%). Los diagnósticos preoperatorios fueron carcinoma papilar variedad convencional (49,3%) y nódulo coloide (28,87%) mientras que los resultados histopatológicos fueron hiperplasia nodular (32,39%) y carcinoma papilar bien diferenciado (44,37%). Se registraron complicaciones postoperatorias en 48,59% pacientes siendo las más frecuentes la hipocalcemia transitoria (84,06%) y hematoma sofocante (2,90%) en las primeras 24 horas y seroma en la primera semana (16,42%); no hubo registro de complicaciones al mes. De acuerdo con las evidencias, la tiroidectomía realizada sin drenaje ha demostrado ser segura y no aumenta las complicaciones postoperatorias a las 24 horas, a la semana, ni al mes de la intervención(AU)


In order to describe the postoperative complications in patients undergoing undrained thyroidectomy who attended the Servicio de Cirugía General of the Hospital Central Universitario Dr. Antonio María Pineda during the period January 2017-January 2018, a cross-sectional descriptive study was conducted through the review of 142 medical charts; patients has an average age of 50.23 ± 12.71 years with predominance of the female sex (88.03%) and normal nutritional status (58.45%). The preoperative diagnoses were conventional papillary carcinoma (49.30%) and colloid nodule (28.87%); the histopathological results were nodular hyperplasia (32.39%) and well differentiated papillary carcinoma (44.37%). 48.59% of patients showed postoperative complications being transient hypocalcemia (84.06%) and suffocating hematoma (2.90%) the most common in the first 24 hours and seroma in the first week (16.42%); there were no reported complications one month after surgery. According to the evidence, thyroidectomy performed without drainage is safe and does not increase postoperative complications at 24 hours, a week, or a month after surgery(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Postoperative Complications , Thyroidectomy , Postoperative Hemorrhage , Thyroid Gland/surgery , Seroma , Hypocalcemia
13.
Arch. endocrinol. metab. (Online) ; 59(5): 434-440, Oct. 2015. tab, graf
Article in English | LILACS | ID: lil-764120

ABSTRACT

Objective This study aimed to evaluate the results of thyroid surgeries with hospitalization periods shorter than 18 hours performed in a surgical endocrinology service, correlating these results with type of procedure, the definitive diagnosis and complications associated with the procedure.Subjects and methods The procedures performed, complications associated, hospitalization period, and relationships among these variables were assessed in consecutive patients subjected to different types of thyroid surgeries from January 1997 to March 2014 by the same group of surgeons. Data were analyzed by frequency, and the associations between the hospitalization period and other variables were analyzed using the Pearson chi-square test and Fisher’s exact test, using a multiple comparisons test with Bonferroni correction.Results Among the 3,411 surgeries performed, 799 of them were malignant neoplasia, 2,505 were benign tumors and 107 were Graves’ disease. The following procedures were performed: total thyroidectomy (1597 patients); total thyroidectomy with neck exploration (369 patients); lobectomy plus isthmectomy (1084 patients); total thyroidectomy complementation (145 patients); total thyroidectomy with neck dissection (84 patients); modified radical total thyroidectomy (13 patients); nodulectomy (11 patients); unresectable (9 patients); central neck dissection (48 patients); lateral neck dissection (38 patients); and others (13 patients). The following surgical complications, characteristic of the procedure: hemorrhage in 41 (1.2%) patients, hypoparathyroidism in 10 (0.3%) patients and recurrent laryngeal nerve (RLN) injury in 23 (0.7%) patients. Hospitalization shorter than 18 hours was observed in 97% of patients.Conclusion Thyroid surgery can be safely performed in virtually all patients on an overnight basis in specialized services.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Young Adult , Length of Stay/statistics & numerical data , Postoperative Hemorrhage/complications , Thyroid Gland/surgery , Thyroidectomy/statistics & numerical data , Drainage/methods , Goiter, Nodular/surgery , Postoperative Period , Retrospective Studies , Recovery Room/statistics & numerical data , Time Factors , Thyroidectomy/methods
14.
Rev. bras. anestesiol ; 65(3): 230-234, May-Jun/2015. tab
Article in English | LILACS | ID: lil-748918

ABSTRACT

BACKGROUND AND OBJECTIVES: Preoperative ultrasonographic evaluation of the thyroid gland done by surgeons could let us foresee airway management challenges. The aim of this observational study was to evaluate the effects of thyroid-related parameters assessed preoperatively by surgeons via ultrasonography and chest X-ray on intubation conditions. METHODS: Fifty patients undergoing thyroid surgery were enrolled. Thyromental distance, Mallampati score, neck circumference and range of neck movement were evaluated before the operation. Thyroid volume, signs of invasion or compression and tracheal deviation on chest X-ray were also noted. The intubation conditions were assessed with Cormack and Lehane score and the intubation difficulty scale. Statistical analyses were done with SPSS 15.0 software. RESULTS: The mean thyroid volume of the patients was 26.38 ± 14 mL. The median intubation difficulty scale was 1 (0-2). Thyromental distance (p = 0.011; r = 0.36; 95% CI 0.582-0.088), Mallampati score (p = 0.041; r = 0.29; 95% CI 0.013-0.526), compression or invasion signs (p = 0.041; r = 0.28; 95% CI 0.006-0.521) and tracheal deviation on chest X-ray (p = 0.041; r = 0.52; 95% CI 0.268-0.702) were correlated with intubation difficulty scale. Also patients were classified into two groups related to their intubation difficulty scale (Group I, n = 19: intubation difficulty scale = 0; Group II, n = 31: 1 < intubation difficulty scale ≤ 5) and difficult intubation predictors and thyroid-related parameters were compared. Only Mallampati score was significantly different between groups (p = 0.025). CONCLUSION: The thyroid volume is not associated with difficult intubation. However clinical assessment parameters may predict difficult intubation. .


JUSTIFICATIVA E OBJETIVOS: A avaliação ultrassonográfica pré-operatória da glândula tireóide feita por cirurgiões pode prever desafios no manejo das vias aéreas. O objetivo deste estudo observacional foi avaliar os efeitos de parâmetros relacionados à tireóide investigados pré-operatoriamente por cirurgiões mediante ultrassonografia e radiografia de tórax em condições de intubação. MÉTODOS: Foram inscritos 50 pacientes submetidos à cirurgia de tireóide. Distância tireomentoniana (DTM), escore de Mallampati, circunferência do pescoço e amplitude de movimento do pescoço foram avaliados antes da operação. Volume da tireóide, sinais de invasão ou compressão e desvio da traqueia na radiografia de tórax também foram registrados. As condições de intubação foram avaliadas com o escore de Cormack e Lehane (CL) e a escala de intubação difícil (EID). Análises estatísticas foram feitas com o software SPSS 15.0. RESULTADOS: A média do volume da tireóide dos pacientes foi de 26,38 ± 14 mL. A mediana da EID foi de 1 (0-2). DTM (p = 0,011; r = 0,36, IC 95% 0,582-0,088); escore de Mallampati (p = 0,041; r = 0,29, IC 95% 013-0,526); sinais de compressão ou invasão (p = 0,041; r = 0,28; IC 95% 0,006-0,521) e desvio da traqueia na radiografia de tórax (p = 0,041; r = 0,52, IC 95% 0,268-0,702) foram correlacionados com a EID. Os pacientes foram classificados em dois grupos também relacionados à EID (Grupo I, n = 19: EID = 0; Grupo II, n = 31: 1 < EID ≤ 5) e os preditivos de intubação difícil e os parâmetros da tireóide relacionados foram comparados. Apenas o escore de Mallampati foi significativamente diferente entre os grupos (p = 0,025). CONCLUSÃO: O volume da tireóide não está associado à intubação difícil. Contudo, os parâmetros de avaliação clínica podem prever intubação difícil. .


JUSTIFICACIÓN Y OBJETIVOS: La evaluación ecográfica preoperatoria de la glándula tiroides hecha por los cirujanos puede prevenir los retos en el manejo de las vías aéreas. El objetivo de este estudio observacional fue evaluar los efectos de parámetros relacionados con la tiroides investigados por cirujanos antes de la operación, mediante ecografía y radiografía de tórax en condiciones de intubación. MÉTODOS: Fueron inscritos 50 pacientes sometidos a cirugía de tiroides. La distancia tiromentoniana, puntuación de Mallampati, circunferencia del cuello y amplitud de movimiento del cuello fueron evaluados antes de la operación. También fueron registrados el volumen de la tiroides, signos de invasión o compresión, y desviación de la tráquea en la radiografía de tórax. Las condiciones de intubación se calcularon con la puntuación de Cormack y Lehane y la escala de intubación difícil (EID). Los análisis estadísticos fueron realizados con el software SPSS 15.0. RESULTADOS: La media del volumen de la tiroides de los pacientes fue de 26,38 ± 14 mL. La mediana de la EID fue 1 (0-2). Fueron correlacionados con la EID la distancia tiromentoniana (p = 0,011; r = 0,36; IC 95%: 0,582-0,088), puntuación de Mallampati (p = 0,041; r = 0,29; IC 95%: 013-0,526), signos de compresión o invasión (p = 0,041; r = 0,28; IC 95%: 0,006-0,521) y desviación de la tráquea en la radiografía de tórax (p = 0,041; r = 0,52; IC 95%: 0,268-0,702). Los pacientes fueron clasificados en 2 grupos también relacionados con la EID (grupo i, n = 19: EID = 0; grupo ii, n = 31: 1 < EID ≤ 5), y los predictores de intubación difícil y los parámetros de la tiroides relacionados fueron comparados. Solamente la puntuación de Mallampati fue significativamente diferente entre los grupos (p = 0,025). CONCLUSIÓN: El volumen de la tiroides no está asociado con la intubación difícil. Sin embargo, los parámetros de evaluación clínica pueden prever la intubación difícil. .


Subject(s)
Humans , Female , Adult , Thyroid Gland/diagnostic imaging , Airway Management/methods , Intubation, Intratracheal/methods , Thyroid Gland/surgery , Preoperative Care/methods , Middle Aged
15.
Rev. guatemalteca cir ; 20(1): 20-25, ene-dic, 2014.
Article in Spanish | LILACS | ID: biblio-1016926

ABSTRACT

Introducción: Tradicionalmente la cirugía tiroidea ha sido practicada bajo anestesia general con intubación endotraqueal. Sin embargo, tomando en cuenta que el riesgo de intubación difícil aumenta en presencia de bocio, que el paso del tubo endotraqueal puede lastimar las cuerdas vocales y que su colocación requiere de relajación muscular y de una laringoscopia con estimulación simpática, el uso de mascarilla laríngea (ML) en cirugía tiroidea pareciera ser una buena alternativa. Con el propósito de determinar si el tamaño del bocio, el diagnóstico de cáncer, el grado de Mallampati y la extensión de la cirugía tiroidea inciden en la dislocación de la ML, se diseñó un estudio incluyendo pacientes con patología tiroidea operados bajo anestesia general con Mascarilla laríngea clásica (MLc). Diseño, lugar y participantes: Se presenta una serie prospectiva de casos, con 168 pacientes sometidos a cirugía tiroidea bajo anestesia general con MLc, operadosde marzo de 1999 a agosto del 2008 en los hospitales Universitario Esperanza y Nuestra Señora del Pilar de la ciudad de Guatemala. Su uso se consideró exitoso cuando la cirugía pudo ser completada con la MLc sin necesidad de sustituirla por intubación endotraqueal. Resultados:La edad promedio de los pacientes fue de 45 años, 148 (88%) fueron del sexo femenino y 20 (22%) del sexo masculino, el tamaño promedio de la glándula tiroides fue de 9.03cm, 166 (99%) tenían Grado I-II de Mallampati, 119 (71%) fueron operados por enfermedad benigna y 49 (29%) por cáncer, a 77 (46%) se les practicó una lobectomía, a 85 (51%) una tiroidectomía total y a 6 (3%) un vaciamiento ganglionar cervical. De los 168 pacientes operados, en 159 (95%) el procedimiento quirúrgico pudo completarsecon la MLc y en 9 pacientes (5%), la MLc fue sustituida por un tubo endotraqueal. Después de análisis univariados y multivariados se pudo establecer que: ni la edad, el sexo, el tamaño de la glándula tiroides, el grado de Mallampati, el diagnóstico histopatológico, ni la extensión de la cirugía, se asociaron estadísticamente con dislocación de la MLc y la necesidad de sustituirla por un tubo endotraqueal. Conclusiones: El uso de la MLc en cirugía tiroidea es posible independientemente del tamaño del bocio, del grado de Mallampati, de la presencia de cáncer y de la extensión de la cirugía.


Background:Traditionally thyroid surgery has been performed under general anesthesia with an endotracheal tube; in the presence of large goiters management of the upper air way using and endotracheal tube can prove to be difficult causing trauma to the vocal chords and requiring a laryngoscopy after neuromuscular blockade. The use of a laryngeal mask could be a valid option in these patients. The aim of this study was to determine if thyroid surgery could be completed using a laryngeal mask. In order to do this, we analyzed if goiter size pathologic diagnosis, Mallampati score and surgical procedure were associated with rates of dislodgement of a classic laryngeal mask (MLc) during thyroid surgery. Design, setting and participants: We present a prospective series of 168 patients who were submitted to thyroid surgery under general anesthesia using an MLc. All surgeries were performed at Hospital Universitario Esperanza and Hospital NuestraSeñora del Pilar in Guatemala City from March 1999 to August 2008. The use of an MLc was considered to be successful if surgery was able to be completed without the need of changing to the use of an endotracheal tube. Results: The average age of our patients was 45 years, 88% (148) were female, the average size of the glands was 9.03 cms., 166 (99%) had a grade I/II Mallampati score, 119 (71%) had a benign diagnosis and 49 (29%) had cancer, 77 (46%) were submitted to a lobectomy, 85 (51%) had a total thyroidectomy and 6 (3%) had a radical neck resection. Thyroid surgery was successfully completed using aMLc in 95% of cases (159). In 9 patients (5%) the MLc was substituted with an endotracheal tube. After univariate and adjusted analysis age, sex, goiter size, Mallampati score, pathologic diagnosis and surgical procedure were not statistically associated with rate of dislodgement of classic laryngeal mask during thyroid surgery. Conclusions: Thyroid surgery is possible using aMLc. This is independent of goiter size, pathologic diagnosis, and the extent of the surgical procedure.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Thyroid Gland/surgery , Laryngeal Masks , Goiter/diagnosis , Anesthesia/methods , Thyroidectomy/methods , Equipment and Supplies
16.
Rev. guatemalteca cir ; 20(1): 46-50, ene-dic, 2014.
Article in Spanish | LILACS | ID: biblio-1016933

ABSTRACT

Anotaciones históricas del desarrollo profesional como cirujano endocrinólogo...


Subject(s)
Humans , Male , Thyroid Gland/surgery , Surgeons/history , Endocrinologists/history , Guatemala
17.
Rev. chil. cir ; 66(4): 320-326, ago. 2014. tab
Article in Spanish | LILACS | ID: lil-719113

ABSTRACT

Introduction: Surgery of the thyroid gland is the most performed procedure by the endocrine surgeon. In the last years, new techniques have been incorporated in this procedure. Our objective is to analyse the impact of these techniques in our department. Methods: We performed a retrospective and comparative study among three samples of patients submitted for total thyroidectomy. Group I: Sample of 96 patients operated between 2004 and 2007 performing total thyroidectomy. In this period we didn't use ultrasonic scalpel (US) nor intraoperative neuromonitoring (INM). Group II: Sample of 108 patients operated between 2008 and 2010. In this group we used US for hemostasis. Group III: Sample of 82 patients operated between 2011 and 2012. In this group we used both US and INM. The groups are compared: complications, postoperative stay, surgical time and costs per patient. Results: We analysed the following complications: haemorrhage, postoperative hipocalcemia and recurrent nerve palsy. We didn't find significant differences among the samples of patients but there were a less percentage of recurrent palsy in the third group (4.9 percent vs 12.5 and 11.1 percent). We found significant differences when stay, surgical time and costs were analysed. Conclusion: The use of new techniques in thyroid surgery has supposed an improvement not only in the clinic outcomes but in the surgical time.


Objetivo: La cirugía de la glándula tiroides representa el procedimiento más frecuente que realiza el cirujano endocrino. En los últimos años se han ido incorporando nuevas técnicas aplicadas a este procedimiento. El objetivo de nuestro trabajo es analizar el impacto que dichas técnicas han tenido en nuestro servicio. Material y Métodos: Estudio retrospectivo y comparativo entre tres muestras de pacientes a los que se realizó tiroidectomía total. Grupo I: Muestra de 96 pacientes intervenidos entre 2004 y 2007 a los que se realizó tiroidectomía total. En este período no se utilizó bisturí ultrasónico (BU) ni neuromonitorización intraoperatoria (NMI). Grupo II: Muestra de 108 pacientes intervenidos entre 2008 y 2010. En este grupo se realizó hemostasia con BU. Grupo III: Muestra de 82 pacientes intervenidos entre 2011 y 2012. Se utilizó tanto el BU como la NMI. Se comparan los grupos en cuanto a: complicaciones, estancia postoperatoria, tiempo quirúrgico y coste por paciente. Resultados: Las complicaciones analizadas fueron: hemorragia, hipocalcemia postoperatoria y parálisis del nervio laríngeo recurrente. No encontramos diferencias significativas entre los grupos aunque sí hay una menor tasa de parálisis recurrenciales en el tercer período (4,9 por ciento vs 12,5 y 11,1 por ciento). Hemos obtenido diferencias significativas en estancia, tiempo quirúrgico y coste por paciente. Conclusión: La inclusión de las nuevas técnicas en cirugía tiroidea ha supuesto una mejora en los resultados clínicos así como un ahorro de tiempo de quirófano.


Subject(s)
Humans , Male , Female , Thyroid Gland/surgery , Thyroidectomy/instrumentation , Thyroidectomy/methods , Cost Efficiency Analysis , Monitoring, Intraoperative , Operative Time , Postoperative Complications , Ultrasonic Surgical Procedures/instrumentation , Retrospective Studies , Surgical Instruments , Treatment Outcome , Thyroidectomy/economics
18.
Cir. parag ; 38(1): 38-40, jun. 2014. ilus
Article in Spanish | LILACS, BDNPAR | ID: biblio-972552

ABSTRACT

Los linfomas primarios de tiroides representan menos del 5% de las neoplasias primarias con elevada asociación con la tiroiditis de Hashimoto y tiroiditis linfocítica. Son tipos histológicos más frecuentes el linfoma B difuso de células grandes y el linfoma B de la zona marginal tipo MALT. Se presenta el caso de una paciente de 46 años que acudió a consultorio por aumento de volumen en región anterior de cuello, asfixia y ronquera. Con el diagnóstico de linfoma tiroideo, la paciente fue sometida a tiroidectomía total. El informe anatomopatológico confirmó el diagnostico de linfoma B de la zona marginal tipo MALT asociado a tiroiditis de Hashimoto, con positividad por inmunohistoquímica para marcadores linfoides B CD20 y CD21.


Primary thyroid lymphomas represent less than 5% of primary tumors with high association with Hashimoto’s thyroiditis and lymphocytic thyroiditis. Most common histological types are diffuse large B-cell lymphoma and lymphoma of MALT type B marginal zone. The case of a 46 year old who came to office by increased volume in anterior neck, choking and hoarseness. With the diagnosis. Thyroid lymphoma . The patient underwent total thyroidectomy. The pathology report confirmed the diagnosis of B lymphoma marginal zone MALT associated with Hashimoto’s thyroiditis, with positivity by immunohistochemistry for B lymphoid markers CD20 and CD21.


Subject(s)
Female , Humans , Middle Aged , Lymphoma, B-Cell/diagnosis , Lymphoma, B-Cell/surgery , Thyroid Gland/surgery , Thyroiditis, Autoimmune
19.
Arq. bras. endocrinol. metab ; 58(4): 402-406, 06/2014. tab, graf
Article in English | LILACS | ID: lil-711639

ABSTRACT

Solitary fibrous tumor (SFT) is an uncommon spindle-cell neoplasm that most often involves the pleura, rarely occurring in extra-thoracic locations. Twenty-six cases of SFT arising in the thyroid gland have been described. We report a case of a 60-year-old woman presenting an 8-month history of enlargement of the neck associated with dysphagia. The patient underwent a right hemithyroidectomy and SFT of the thyroid was diagnosed. Immunohistochemistry showed positivity for CD34 marker, and the high number of mitoses and the presence of cellular atypia suggested that the tumor was malignant. To our knowledge, this is the second case of malignant SFT of the thyroid gland ever reported. Due to the rarity of these tumors, the indication of adjuvant therapy and prognosis are uncertain. Long-term follow-up after surgical resection seems to be advisable.


O tumor fibroso solitário (SFT) é uma neoplasia rara de células fusiformes que mais frequentemente envolve a pleura, raramente ocorrendo em áreas extratorácicas. Já foram descritos 26 casos de SFT da tiroide. Relatamos o caso de uma paciente de 60 anos de idade com um histórico de 8 meses de aumento do pescoço associado à disfagia. A paciente foi submetida a uma hemitiroidectomia direita e foi diagnosticado um SFT de tiroide. A imuno-histoquímica mostrou resultados positivos para o marcador CD34, e o grande número de mitoses e a presença de atipia celular sugerem que o tumor era maligno. Em nosso conhecimento, este é o segundo caso de STF da tiroide maligno já relatado. Dada a rara ocorrência desses tumores, a indicação de tratamento adjuvante e o prognóstico são incertos. Recomenda-se o acompanhamento de longo prazo depois da ressecção cirúrgica.


Subject(s)
Female , Humans , Middle Aged , Carcinoma/pathology , Rare Diseases/pathology , Solitary Fibrous Tumors/pathology , Thyroid Gland/pathology , Thyroid Neoplasms/pathology , Age of Onset , /analysis , Carcinoma/surgery , Follow-Up Studies , Long-Term Care , Rare Diseases/surgery , Solitary Fibrous Tumors/surgery , Thyroid Gland/surgery , Thyroid Neoplasms/surgery
20.
Arq. bras. endocrinol. metab ; 58(3): 292-300, abr. 2014. tab, graf
Article in English | LILACS | ID: lil-709355

ABSTRACT

Objective : Current guidelines have advised against the performance of 131I-iodide diagnostic whole body scintigraphy (dxWBS) to minimize the occurrence of stunning, and to guarantee the efficiency of radioiodine therapy (RIT). The aim of the study was to evaluate the impact of stunning on the efficacy of RIT and disease outcome.Subjects and methods : This retrospective analysis included 208 patients with differentiated thyroid cancer managed according to a same protocol and followed up for 12-159 months (mean 30 ± 69 months). Patients received RIT in doses ranging from 3,700 to 11,100 MBq (100 mCi to 300 mCi). Post-RIT-whole body scintigraphy images were performed 10 days after RIT in all patients. In addition, images were also performed 24-48 hours after therapy in 22 patients. Outcome was classified as no evidence of disease (NED), stable disease (SD) and progressive disease (PD).Results : Thyroid stunning occurred in 40 patients (19.2%), including 26 patients with NED and 14 patients with SD. A multivariate analysis showed no association between disease outcome and the occurrence of stunning (p = 0.3476).Conclusion : The efficacy of RIT and disease outcome do not seem to be related to thyroid stunning. Arq Bras Endocrinol Metab. 2014;58(3):292-300.


Objetivo : As diretrizes atuais alertam contra a execução da cintigrafia de corpo inteiro com iodo-131 (dxWBS) para minimizar a ocorrência de atordoamento e garantir a eficiência do tratamento com radioiodo (RIT). O objetivo deste estudo foi avaliar o impacto do atordoamento sobre a eficácia do RIT e desfechos da doença.Sujeitos e métodos : Esta análise retrospectiva incluiu 208 pacientes com câncer diferenciado de tireoide submetidos ao mesmo protocolo e acompanhados por 12-159 semanas (média de 30 ± 69 meses). Os pacientes receberam RIT com doses variando de 3.700 a 11.100 MBq (100 mCi a 300 mCi). As imagens da cintigrafia após a RIT foram feitas 10 dias depois da RIT em todos os pacientes. Além disso, as imagens foram também obtidas após 24-48h em 22 pacientes. O desfecho foi classificado como nenhuma evidência de doença (NED), doença estável (SD) e doença progressiva (PD).Resultados : O atordoamento da tireoide ocorreu em 40 pacientes (19,2%), incluindo 26 pacientes com NED e 14 pacientes com SD. A análise multivariada não mostrou associação entre o desfecho da doença e a ocorrência de atordoamento (p = 0,3476).Conclusão : A eficácia da RIT e o desfecho da doença não parecem estar relacionados com o atordoamento da tireoide. Arq Bras Endocrinol Metab. 2014;58(3):292-300.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Adenocarcinoma, Follicular/radiotherapy , Carcinoma, Papillary/radiotherapy , Iodine Radioisotopes/therapeutic use , Thyroid Gland , Thyroid Neoplasms/radiotherapy , Disease Progression , Iodine Radioisotopes/administration & dosage , Multivariate Analysis , Retrospective Studies , Thyroidectomy , Treatment Outcome , Thyroid Gland/surgery , Thyroid Neoplasms/classification , Whole Body Imaging
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