2,459 research outputs found
The middle thyroid vein: anatomical and surgical aspects
No full textAn issue that has been overlooked in medical literature concerns the prevalence and topographic relationships of the middle thyroid vein (MTV), which have been studied, with a prospective approach, in patients with various thyroid diseases.MTV prevalence has been investigated in 394 consecutive lobes and a number of different variables (age, gender, thyroid pathology, gland weight) have been considered. Moreover, in cooperation with our Human Morphology Department, we brought to completion a dedicated anatomy report, with the clear objective of providing a detailed anatomic description of MTV.The prevalence of MTV was 38\% of the dissected lobes and 62\% of operated patients. Most veins arise from the mid region of the thyroid lobe (80\%): B, 3, and 2 positions in accordance with our scheme. As far as thyroid pathology is concerned, we found that the presence of MTV was more frequent in hyperthyroidism and large goiters (p < 0.05).A better understanding of the anatomic variability in MTV may be useful not only to minimize the risk of bleeding, but it also can help to perform a more accurate dissection with the goal of preserving the laryngeal nerves and parathyroid glands, especially because of its location and relationships with other adjacent structures
Commentary on transoral access for endoscopic thyroid resecition: Witzel K, von Rahden BH, Kaminski C, Stein HJ (2008) Transoral access for endoscopic thyroid resection. Surg Endosc 22(8): 1871-1875
No full textNatural orifices transluminal endoscopic surgery (NOTEA) and other allied "ultra" minimally invasive procedures: are we loosing the plot?
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Dissection and hemostasis with hydroxilated polyvinyl acetal tampons in open thyroid surgery
No full textBackground: The essential objectives for thyroidectomy are: avoidance of injury to the recurrent laryngeal nerves, conservation of the parathyroid glands, an accurate haemostasis and an excellent cosmesis. In the last 10 years major improvements and new technologies have been proposed and applied in thyroid surgery; among these mini-invasive thyroidectomy, regional anaesthesia and intraoperative neuromonitoring, and new devices for achieving dissection and haemostasis. Minor bleeding from small vessels could be a major complication in thyroid surgery. The purpose of ligating vessels is to maintain the surgical site free from an excess of blood and reduce blood loss in the patient.
Materials and methods: Hydroxylated polyvinyl acetal tampons (HPA) are made by a synthetic, open cell foam structure able to absorb fluids up to 25 times the initial weight. We tested their efficacy for small bleeding control and tissue dissection during several thyroid procedures.
Results: HPA tampons have been found extremely useful to absorb blood coming from minor and diffuse loss, helping to control bleeding by a combined action of fluid absorption and local compression. The porous design of the tampon allows the use of the suction device right through the tampon itself. Thanks to the initial mildly hard consistency, we also used HPA tampons as dissecting instruments.
Conclusion: In our experience the use of HPA tampons resulted extremely efficient for minor bleeding control, fluids removal and tissue dissection during thyroid surgery
Diagnosi precoce del cancro del polmone. Il progetto PRE.DI.CA. a Varese
No full textTribuna Medica Ticines
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