Robot Assisted Trans Axillary Thyroidectomy: A Subcontinent Experience

Abstract To evaluate the outcome and initial hurdles of transaxillary robotic thyroidectomy in the Indian subcontinent. A total of seven (n  = 7) patients were operated from August 2016 to February 2017. Ultrasonography was used as a tool to decide the size of thyroid lobe and fine needle aspiration cytology for the type of lesion. All patients underwent ipsilateral brachial plexus nerve conduction studies preoperatively. Two arm po sitions were evaluated. The robot was docked at the contralateral side of the surgical field. Before discharge from hospital, all patients were given a questionnaire evaluate outcome. Set 1 was answered on the day of discharge and Set 2 at one-month follow up. The most common pathology in our case s eries was colloid goiter (n = 4) followed by follicular lesion (n = 3). The mean console time was 167 min, with initial two cases taking more than 200 min. The maximum and minimum length of the axillary tunnel was 16 and 27 cm respectively. There was no difference with regard to complicat ion rate with either arm position. None of the patients developed brachial plexus injury and was confirmed by normal nerve conduction study done on postoperative day three. In our experience with transaxillary robotic thyroidectomy, the problems we faced in our population were unique considering the varied physical parameters. Use of malleable retractors comes handy in these situation and we recommend the use ...
Source: Indian Journal of Otolaryngology and Head and Neck Surgery - Category: ENT & OMF Source Type: research

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AbstractRET proto-oncogene (RET) mutations were proved to be related to the development of medullary thyroid carcinoma (MTC). We aimed to analyze the role ofRET mutations in cervical lymph node metastasis in patients with MTC. Forty-nine patients with preoperatively diagnosed MTC by fine-needle aspiration cytology (FNAC) who underwent bilateral total thyroidectomy with cervical lymphadenectomy were included. PostoperativeRET gene test and pathological analysis were performed with the surgical specimens; serum calcitonin (Ctn) and carcinoembryonic antigen (CEA) levels were tested pre- and postoperatively, to evaluate the as...
Source: Endocrine Pathology - Category: Pathology Source Type: research
Although frequently used as an adjunct to cytology in patients with differentiated thyroid cancers, interpretation of thyroglobulin washout remains unclear. We aim to compare the utility of different analytic tools to develop recommendations for use in post-total thyroidectomy follow-up.
Source: Surgery - Category: Surgery Authors: Source Type: research
This study reviewed the medical records of 996 LLNs from 858 patients with suspicious thyroid nodules or after thyroidectomy from January 2013 to January 2016. All patients took US-FNA. The US characteristics and the malignancy rate of LLNs classified into group A and group B based on size were analyzed and compared (group A, ≥6 mm; group B, 0.005) in multiple regression analysis, whereas the malignancy rate in the large LLNs (286/425; 67.3%) was slightly higher than that in the small LLNs (338/571; 59.2%) (P = 0.01). However, no significant difference was observed between the groups in terms of calcification, absence o...
Source: Ultrasound Quarterly - Category: Radiology Tags: Original Research Source Type: research
CONCLUSIONS: Because of the association between FAP or colon cancer with multifocal CMV-PTC, we confirm that an analysis of APC gene mutation and colonoscopy should be carried-out in these patients when multiple thyroid tumors are found. PMID: 31469036 [PubMed - as supplied by publisher]
Source: Thyroid : official journal of the American Thyroid Association - Category: Endocrinology Tags: Thyroid Source Type: research
AbstractIgG4-related disease of the thyroid gland is a recently recognized subtype of thyroiditis, often with rapid progression requiring surgical treatment. It is considered as a spectrum of disease varying from early IgG4-related Hashimoto ’s thyroiditis (HT) pattern to late fibrosing HT or Riedel’s thyroiditis patterns. Here, we report a 47-year-old Malay woman presenting with progressively painless neck swelling over 3 years and subclinical hypothyroidism. Computed tomography (CT) scan revealed diffuse thyroid enlargement (up t o 13 cm) with retrosternal extension and without regional lymphadenopa...
Source: Head and Neck Pathology - Category: Pathology Source Type: research
Rationale: The inferior parathyroid glands derive from the third branchial pouch and seldom ectopically migrate to thyroid grand, mediastinum, thymus. Ectopic intrathyroidal parathyroid grand (ETPG) is rare and it cannot be consistently detected by any imaging examinations. The unusual ETPG is easily resected during thyroidectomy, which might cause postoperative hypoparathyroidism. Auto-transplantation of even a parathyroid gland can restore parathyroid function to some extent. Until now, there are not any guidelines on the management of ETPG. Patient concerns: Without any symptoms, a 27-year-old female patient was ad...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Conclusion: Since most FN cytology has been pathologically diagnosed with papillary cancer and some papillary cancer subtypes have been unfavorable pathologically, total thyroidectomy should be the most suitable treatment option in this group. Lobectomy with LwI is not suitable for patients with FNAB-proven FN cytology. PMID: 31340635 [PubMed - as supplied by publisher]
Source: Turkish Journal of Medical Sciences - Category: General Medicine Tags: Turk J Med Sci Source Type: research
In conclusion, for a more precise diagnosis, we suggest these markers be included in what is currently available to characterize malignancy from what is not in thyroid cancer, as well as for the staging process of PTC. PMID: 31341476 [PubMed]
Source: Journal of Oncology - Category: Cancer & Oncology Tags: J Oncol Source Type: research
This study was carried out to evaluate the requirement of routine thyroidectomise with total laryngectomy. An analysis of the final histology of 83 patients, who underwent the traditional treatment, together with the preoperative contrast enhanced CT scan was carried out. Among 58 cases of T3 carcinoma larynx 2 revealed thyroid involvement by metastasis (3.45%), 1 of them was suspected in preoperative CT and confirmed by FNAC. Among 25 cases of T4a carcinoma larynx 6 revealed thyroid involvement by direct extension (24%) with evidence of same in preoperative CT. Risk of thyroid involvement is low in T3 cases (3.45%) and is...
Source: Indian Journal of Otolaryngology and Head and Neck Surgery - Category: ENT & OMF Source Type: research
CONCLUSIONS: A novel diagnostic tool with potential application in preoperative screening of thyroid nodules is reported here. The proposed protocol has the potential to avoid unnecessary thyroidectomies. PMID: 31328658 [PubMed - as supplied by publisher]
Source: Thyroid : official journal of the American Thyroid Association - Category: Endocrinology Tags: Thyroid Source Type: research
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