Advanced Search

Home > Journals > Minerva Chirurgica > Past Issues > Minerva Chirurgica 2007 October;62(5) > Minerva Chirurgica 2007 October;62(5):359-72

ISSUES AND ARTICLES   MOST READ   eTOC

CURRENT ISSUEMINERVA CHIRURGICA

A Journal on Surgery

Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,877

Frequency: Bi-Monthly

ISSN 0026-4733

Online ISSN 1827-1626

 

Minerva Chirurgica 2007 October;62(5):359-72

    REVIEWS

Current indications for thyroidectomy

Dionigi G. 1, Dionigi R. 1, Bartalena L. 2, Tanda M. L.2, Piantanida E. 2, Castano P. 1, Annoni M. 1, Boni L. 1, Rovera F. 1, Bacuzzi A. 3, Vanoli P. 4, Sessa F. 5

1 Centro di Ricerche in Endocrinochirurgia Dipartimento di Scienze Chirurgiche Università degli Studi dell’Insubria, Varese
2 Cattedra di Endocrinologia Dipartimento di Medicina Clinica Università degli Studi dell’Insubria, Varese
3 Servizio di Anestesia e Rianimazione Ospedale di Circolo, Fondazione Macchi Polo Universitario, Varese
4 Divisione di Radioterapia Ospedale di Circolo, Fondazione Macchi Polo Universitario, Varese
5 Cattedra di Anatomia Patologica Dipartimento di Morfologia Umana Università degli Studi dell’Insubria, Varese

Thyroid surgery, one of the most common interventions in endocrine surgery, is practiced by many specialists who perform this procedure exclusively. It accounts for the bulk of work even in reference centers that treat rare endocrine tumors (e.g. adrenal and gastrointestinal tract cancer). Better results are obtained by experienced and skilled operators. Surgeons who correctly perform thyroid surgery can achieve excellent outcomes even in other areas of endocrine surgery. So it is surprising that not more is being done to teach the procedure, which has always been considered something of an art, perhaps because surgical treatment of rare endocrine tumors is more stimulating to teach than routine surgical procedures. Nonetheless, teaching correct surgical technique is essential for reducing and avoiding postoperative complications caused by inadequate experience and knowledge. Numerous studies have reported that the incidence of complications is high and that the rate is growing: 5% involve permanent injury to the recurrent laryngeal nerve after intervention for a benign tumor, despite repeated reports that the incidence could be reduced to near zero or at least to 1%. Alarmingly high is the 20% incidence of persistent hypoparathyroidism after total thyroidectomy. Here, too, accurate technique could reduce this rate to 1%. An important point is that permanent laryngeal nerve injury and persistent hypoparathyroidism are both sources of considerable discomfort for patients. One of the chief objectives of modern endocrine surgery is, therefore, to reduce the complications rate to acceptable levels by establishing adequate, uniform teaching protocols and universal guidelines that would help improve the practice of surgery.

language: Italian


FULL TEXT  REPRINTS

top of page