1,720,964 research outputs found
Thyroid surgery before the technological revolution: From Samuel Gross' "torrents of blood" to Paolo Miccoli's video-assisted thyroidectomy
No full text"Can the thyroid gland... be removed with a reasonable hope of saving the patient?... If a surgeon should be so foolhardy as to undertake it... every step he takes will be followed by a torrent of blood, and lucky will it be for him if his victim live long enough to enable him to finish his horrid butchery... no honest and sensible surgeon would ever engage in it". With this renowned posthumous declaration, in 1886, Samuel D. Gross proposed that thyroid surgery should have been abandoned by surgeons. Despite this, subsequent improvements in anesthesiology, antisepsis strategies and better surgical instruments allowed to significantly decrease the mortality rates of this surgery to nearly zero percent, as is the case now. This paper aims at highlighting the most important steps and Mentors that led thyroid surgery to become one of the safest and most widespread surgical procedures
Scritture di immagini. Arti verbovisuali, dal secondo Novecento a oggi. Avanguardia, neoavanguardia, comunicazione di massa / Image Writing. Verbo-Visual Arts from the Late Twentieth Century to Today. Avant-Garde, Neo-Avant-Garde, Mass Communication
Full text linkEditoriale / Editorial. Scritture di immagini. Arti verbovisuali, dal secondo Novecento a oggi. Avanguardia, neoavanguardia, comunicazione di massa / Image Writing. Verbo-Visual Arts from the Late Twentieth Century to Today. Avant-Garde, Neo-Avant-Garde, Mass Communication
No full textHow to Use Energy Devices and their Potential Hazards
No full textModern thyroid surgery has been substantially modified by the impact of devices/instruments that, using different forms of energy (mainly radiofrequency and harmonic technology), allow a bloodless dissection of the surgical field. Among many advantages, these instruments are responsible, for example, for the significant reduction of the incision size, which may be one of the main concerns of patients undergoing thyroid surgery. Nevertheless, even if they are sa-fer than the common monopolar electrocautery, to be properly used all these instruments have a learning curve necessary to avoid damage that may affect the patient's quality of life. This chapter analyses the technology behind the more commonly used devices, and discusses the results and advantages obtained when using them to perform a thyroidectomy. © 2013 John Wiley & Sons, Ltd
Differentiated thyroid carcinoma: Prognostic stratification and molecular classification
No full textDifferentiated nonmedullary thyroid cancers (DTCs) are highly differentiated tumors that in most of the cases have a very good prognosis but may sometimes lead the patient to death despite aggressive treatments. Many classifications exist that stratify the clinical risk of recurrence or death in patients with DTC through several prognostic factors, which are often
diagnosed after surgical treatment. This chapter aims to give a description of the two main categories of prognostic characteristics that are currently used by those involved in the treatment of DTC: the clinicopathological factors and the molecular ones
Minimally Invasive Video-assisted Thyroidectomy
No full textThe minimally invasive video-assisted thyroidectomy (MIVAT) was developed in Pisa in 1998, and described in 1999. It has now become the most widespread minimally invasive technique for thyroidectomy throughout the world. This technique cannot be applied to every patient undergoing thyroid surgery but has precise indications, mainly in terms of size of the thyroid gland and nature of the thyroid disease. Only low and intermediate differentiated thyroid cancers under 2cm should be selected for MIVAT. © 2013 John Wiley & Sons, Ltd
Minimally Invasive Techniques Performed Through the Neck Access
No full textMinimally invasive video-assisted thyroidectomy currently represents the most widely performed technique for minimally invasive thyroidectomy in western countries. The particular complications of the minimally invasive video-assisted thyroidectomy technique will be discussed. We will focus specifically on the relevant aspects and management of well-known complications (e.g. postoperative bleeding) during and after this minimally invasive procedure, and on how to avoid them. © 2013 John Wiley & Sons, Ltd
Morbidity following thyroid surgery: acceptable rates and how to manage complicated patients
No full textPurpose: The endocrine surgeon and the endocrinologist should standardize how they deal with patients with an indication for thyroidectomy, as the road to surgery starts well before the operation itself. The patient should be thoroughly informed about where and how surgery will be performed, the postoperative improvements that can be expected, and the possibility and incidence of relevant complications. This short review aims at identifying the most common postoperative issues after thyroidectomy, with the relevant therapeutic suggestions. Methods: A revision of studies reporting the morbidity of thyroid surgery, involving the largest numbers of patients. Results: It has been clearly demonstrated that the outcome of thyroid surgery is significantly better when the procedure is performed by an experienced surgeon. Thus, the number of thyroidectomies performed by a surgeon should drive the endocrinologist when referring a patient. Conclusions: Despite the surgeon's experience, thyroidectomy is burdened by a relatively high rate of postoperative issues ranging from less severe ones to others causing significant changes in the patient’s quality of life. Minor, non-invalidating symptoms have been described in 40% of patients after thyroidectomy (e.g. hoarseness, mild dysphagia, some degree of voice alteration); however, these symptoms usually resolve within a few months of surgery, with or without early treatment. On the other hand, major postoperative complications are observed in a limited number of patients, but in these cases early diagnosis is important to provide the most appropriate postoperative treatment, and thus hasten full recovery or at least achieve the greatest possible improvement
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