Abstract
Thyroid and parathyroid surgery might be considered perhaps among the most anatomically challenging surgery within medicine, with the surgeon requiring fine dexterity and detailed anatomical knowledge to avoid potentially catastrophic complications. This chapter deals with the repertoire of complications, risks, consequences, and difficulties that may be encountered with thyroid and parathyroid surgery and provides some information and discussion that may assist toward reduction of these problems. For other associated procedures, refer to other relevant chapters and volumes.
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Further Reading, References, and Resources
Partial Thyroidectomy (Hemithyroidectomy; Thyroid Lobectomy)
Åkerstrom G, Malmaeus J, Bergstrom R. Surgical anatomy of human parathyroid glands. Surgery. 1984;95:14.
Barczyński M, Konturek A, Stopa M, Papier A, Nowak W. Minimally invasive video-assisted thyroidectomy: seven-year experience with 240 cases. Wideochir Inne Tech MaloInwazyjne. 2012;7(3):175–80.
Chandrasekhar SS, Randolph GW, Seidman MD, Rosenfeld RM, Angelos P, Barkmeier-Kraemer J, Benninger MS, Blumin JH, Dennis G, Hanks J, Haymart MR, Kloos RT, Seals B, Schreibstein JM, Thomas MA, Waddington C, Warren B, Robertson PJ. Clinical practice guideline: improving voice outcomes after thyroid surgery. Otolaryngol Head Neck Surg. 2013;148(6 Suppl):S1–37.
Clemente CD. Anatomy – a regional atlas of the human body. 4th ed. Baltimore: Williams and Wilkins; 1997.
Durante C, Montesano T, Torlontano M, Attard M, Monzani F, Tumino S, Costante G, Meringolo D, Bruno R, Trulli F, Massa M, Maniglia A, D’Apollo R, Giacomelli L, Ronga G, Filetti S, PTC Study Group. Papillary thyroid cancer: time course of recurrences during postsurgery surveillance. J Clin Endocrinol Metab. 2013;98(2):636–42.
Eisel DW. Complications of thyroid surgery. In: Eisele DW, editor. Complications in head and neck surgery. St. Louis: Mosby; 1993.
Frank RW, Middleton L, Stack Jr BC, Spencer HJ, Riggs AT, Bodenner DL. Conservative management of thyroglobulin-positive, nonlocalizable thyroid carcinoma. Head Neck. 2013 (Epub ahead of print)
Hay ID. Ipsilateral lobectomy versus bilateral lobar resection for papillary carcinoma of the thyroid: a retrospective analysis of surgical outcome using a novel prognostic scoring system. Surgery. 1987;102:1088.
Henry JF, Audiffret J, Denizot A. The nonrecurrent inferior laryngeal nerve: review of 33 cases, including two on the left side. Surgery. 1988;104:977.
Hisham AN, Lukman MR. Recurrent laryngeal nerve in thyroid surgery: a critical appraisal. ANZ J Surg. 2002;72(12):887–9.
Ibrahimpasic T, Ghossein R, Carlson DL, Chernichenko N, Nixon I, Palmer FL, Lee NY, Shaha AR, Patel SG, Tuttle RM, Balm AJ, Shah JP, Ganly I. Poorly differentiated thyroid carcinoma presenting with gross extrathyroidal extension: 1986–2009 Memorial Sloan-Kettering Cancer Center experience. Thyroid. 2013;23(8):997–1002.
Jamieson GG. The anatomy of general surgical operations. 2nd ed. Edinburgh: Churchill Livingston; 2006.
Jeong JJ, Kim KH, Koh YW, Nam KH, Chung WY, Park CS. Surgical completeness of total thyroidectomy using harmonic scalpel: comparison with conventional total thyroidectomy in papillary thyroid carcinoma patients. J Korean Surg Soc. 2012;83(5):267–73.
Lo CY, Kwoh KF, Yuen PW. A prospective evaluation of recurrent laryngeal nerve paralysis during thyroidectomy. Arch Surg. 2000;135:204.
Loyo M, Tufano RP, Gourin CG. National trends in thyroid surgery and the effect of volume on short-term outcomes. Laryngoscope. 2013;123(8):2056–63.
Maeda T, Saito M, Otsuki N, Morimoto K, Takahashi M, Iwaki S, Inoue H, Tomoda C, Miyauchi A, Nibu KI. Quality of voice after surgical treatment for thyroid cancer. Thyroid. 2013;23(7):847–53.
Olson Jr JA, DeBenedetti MK, Baumann DS, Wells Jr SA. Parathyroid autotransplantation during thyroidectomy: results of long-term follow-up. Ann Surg. 1996;223:472.
Palme CE, Waseem Z, Raza SN, et al. Management and outcome of recurrent well-differentiated thyroid carcinoma. Arch Otolaryngol Head Neck Surg. 2004;130(7):819–24.
Pellegriti G, Mannarino C, Russo M, Terranova R, Marturano I, Vigneri R, Belfiore A. Increased mortality in patients with differentiated thyroid cancer associated with Graves’ disease. J Clin Endocrinol Metab. 2013;98(3):1014–21.
Sadowski SM, Soardo P, Leuchter I, Robert JH, Triponez F. Systematic use of recurrent laryngeal nerve neuromonitoring changes the operative strategy in planned bilateral thyroidectomy. Thyroid. 2013;23(3):329–33.
Smith JJ, Chen X, Schneider DF, Broome JT, Sippel RS, Chen H, Solórzano CC. Cancer after thyroidectomy: a multi-institutional experience with 1,523 patients. J Am Coll Surg. 2013;216(4):571–7; discussion 577–9.
Tuttle RM, Sabra MM. Selective use of RAI for ablation and adjuvant therapy after total thyroidectomy for differentiated thyroid cancer: a practical approach to clinical decision making. Oral Oncol. 2013;49(7):676–83.
Wang SF, Zhao WH, Wang WB, Teng XD, Teng LS, Ma ZM. Clinical features and prognosis of patients with benign thyroid disease accompanied by an incidental papillary carcinoma. Asian Pac J Cancer Prev. 2013;14(2):707–11.
Subtotal Thyroidectomy
Åkerstrom G, Malmaeus J, Bergstrom R. Surgical anatomy of human parathyroid glands. Surgery. 1984;95:14.
Barczyński M, Konturek A, Stopa M, Papier A, Nowak W. Minimally invasive video-assisted thyroidectomy: seven-year experience with 240 cases. Wideochir Inne Tech MaloInwazyjne. 2012;7(3):175–80.
Chandrasekhar SS, Randolph GW, Seidman MD, Rosenfeld RM, Angelos P, Barkmeier-Kraemer J, Benninger MS, Blumin JH, Dennis G, Hanks J, Haymart MR, Kloos RT, Seals B, Schreibstein JM, Thomas MA, Waddington C, Warren B, Robertson PJ. Clinical practice guideline: improving voice outcomes after thyroid surgery. Otolaryngol Head Neck Surg. 2013;148(6 Suppl):S1–37.
Chi SY, Hsei KC, Sheen-Chen SM, et al. A prospective randomized comparison of bilateral subtotal thyroidectomy versus unilateral total and contralateral subtotal thyroidectomy for Graves’ disease. World J Surg. 2005;29(2):160–3.
Clemente CD. Anatomy – a regional atlas of the human body. 4th ed. Baltimore: Williams and Wilkins; 1997.
Durante C, Montesano T, Torlontano M, Attard M, Monzani F, Tumino S, Costante G, Meringolo D, Bruno R, Trulli F, Massa M, Maniglia A, D'Apollo R, Giacomelli L, Ronga G, Filetti S; PTC Study Group. Papillary thyroid cancer: time course of recurrences during postsurgery surveillance. J Clin Endocrinol Metab. 2013;98(2):636–42.
Eisel DW. Complications of thyroid surgery. In: Eisele DW, editor. Complications in head and neck surgery. St. Louis: Mosby; 1993.
Frank RW, Middleton L, Stack Jr BC, Spencer HJ, Riggs AT, Bodenner DL. Conservative management of thyroglobulin-positive, nonlocalizable thyroid carcinoma. Head Neck. 2013 (Epub ahead of print)
Hay ID. Ipsilateral lobectomy versus bilateral lobar resection for papillary carcinoma of the thyroid: a retrospective analysis of surgical outcome using a novel prognostic scoring system. Surgery. 1987;102:1088.
Henry JF, Audiffret J, Denizot A. The nonrecurrent inferior laryngeal nerve: review of 33 cases, including two on the left side. Surgery. 1988;104:977.
Ibrahimpasic T, Ghossein R, Carlson DL, Chernichenko N, Nixon I, Palmer FL, Lee NY, Shaha AR, Patel SG, Tuttle RM, Balm AJ, Shah JP, Ganly I. Poorly differentiated thyroid carcinoma presenting with gross extrathyroidal extension: 1986–2009 Memorial Sloan-Kettering Cancer Center experience. Thyroid. 2013;23(8):997–1002.
Jamieson GG. The anatomy of general surgical operations. 2nd ed. Edinburgh: Churchill Livingston; 2006.
Jeong JJ, Kim KH, Koh YW, Nam KH, Chung WY, Park CS. Surgical completeness of total thyroidectomy using harmonic scalpel: comparison with conventional total thyroidectomy in papillary thyroid carcinoma patients. J Korean Surg Soc. 2012;83(5):267–73.
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Loyo M, Tufano RP, Gourin CG. National trends in thyroid surgery and the effect of volume on short-term outcomes. Laryngoscope. 2013;123(8):2056–63.
Maeda T, Saito M, Otsuki N, Morimoto K, Takahashi M, Iwaki S, Inoue H, Tomoda C, Miyauchi A, Nibu KI. Quality of voice after surgical treatment for thyroid cancer. Thyroid. 2013;23(7):847–53.
Olson Jr JA, DeBenedetti MK, Baumann DS, Wells Jr SA. Parathyroid autotransplantation during thyroidectomy: results of long-term follow-up. Ann Surg. 1996;223:472.
Ozbas S, Kocak S, Aydintug S, et al. Comparison of the complications of subtotal, near total and total thyroidectomy in the surgical management of multinodular goiter. Endocr J. 2005;52(2):199–205.
Pellegriti G, Mannarino C, Russo M, Terranova R, Marturano I, Vigneri R, Belfiore A. Increased mortality in patients with differentiated thyroid cancer associated with Graves’ disease. J Clin Endocrinol Metab. 2013;98(3):1014–21.
Sadowski SM, Soardo P, Leuchter I, Robert JH, Triponez F. Systematic use of recurrent laryngeal nerve neuromonitoring changes the operative strategy in planned bilateral thyroidectomy. Thyroid. 2013;23(3):329–33.
Smith JJ, Chen X, Schneider DF, Broome JT, Sippel RS, Chen H, Solórzano CC. Cancer after thyroidectomy: a multi-institutional experience with 1,523 patients. J Am Coll Surg. 2013;216(4):571–7; discussion 577–9.
Tuttle RM, Sabra MM. Selective use of RAI for ablation and adjuvant therapy after total thyroidectomy for differentiated thyroid cancer: a practical approach to clinical decision making. Oral Oncol. 2013;49(7):676–83.
Wang SF, Zhao WH, Wang WB, Teng XD, Teng LS, Ma ZM. Clinical features and prognosis of patients with benign thyroid disease accompanied by an incidental papillary carcinoma. Asian Pac J Cancer Prev. 2013;14(2):707–11.
Total Thyroidectomy
Thyroidectomy Technique, Complications and Outcomes
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Nerve Injury
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Bliss R, Gauger P, Delbridge L. Surgeons approach to the thyroid gland: surgical anatomy and importance of technique. World J Surg. 2000;24:891–7.
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Henry JF, Audiffret J, Denizot A. The nonrecurrent inferior laryngeal nerve: review of 33 cases, including two on the left side. Surgery. 1988;104:977
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Wound Drains
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Anatomy
Clemente CD. Anatomy – a regional atlas of the human body. 4th ed. Baltimore: Williams and Wilkins; 1997.
Jamieson GG. The anatomy of general surgical operations. 2nd ed. Edinburgh: Churchill Livingston; 2006.
Parathyroid Exploration and Parathyroidectomy
Åkerstrom G, Malmaeus J, Bergstrom R. Surgical anatomy of human parathyroid glands. Surgery. 1984;95:14.
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Giuliano, A., Wells, S., Reeve, T., Abdullah, H., Coventry, B.J. (2014). Thyroid and Parathyroid Surgery. In: Coventry, B. (eds) Breast, Endocrine and Surgical Oncology. Surgery: Complications, Risks and Consequences. Springer, London. https://doi.org/10.1007/978-1-4471-5421-1_3
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