1.
Clinical effect of total thyroidectomy combined with radioactive iodine in thyroid cancer treatment.
Yin, X, Li, Z, Zhang, Z, Song, L, Wang, X
Pakistan journal of pharmaceutical sciences. 2018;(4(Special)):1675-1678
Abstract
Aim of this research work is to observe and analyze the clinical effect of total thyroidectomy combined with radioactive iodine in thyroid cancer treatment. The 120 thyroid cancer patients treated in our hospital were enrolled as study subjects and assigned to study group (treated with total thyroidectomy and radioactive iodine) and reference group (treated with conventional total thyroidectomy). The overall treatment efficacy was compared between the two groups. Comparison of overall treatment efficacy of the two groups showed that the study group has superior results to the reference group (P<0.05). Comparison of incidence of recurrent laryngeal nerve injury in the two groups revealed no significant differences, P>0.05. However, in life quality assessment, the study group was significantly superior to the reference group in terms of physiological function, psychological function, social function, and overall life quality scores, P<0.05. Total thyroidectomy combined with radioactive iodine can well improve the overall treatment efficiency and enable patients to have higher quality of life at the same time.
2.
Postoperative PTH measurement facilitates day 1 discharge after total thyroidectomy.
Grodski, S, Lundgren, CI, Sidhu, S, Sywak, M, Delbridge, L
Clinical endocrinology. 2009;(2):322-5
Abstract
OBJECTIVE A new protocol for postoperative calcium management was developed with the aim of achieving an increase in the proportion of patients being safely discharged on the first postoperative day. We present our experience with the first 50 patients treated under this new protocol. PATIENTS AND DESIGN A cohort study was performed involving the first 50 patients admitted for total or completion thyroidectomy, those data were then compared with a control group. Intact PTH (iPTH) was measured at 4-h postoperatively and patients with iPTH in the normal range were discharged on the first postoperative day. RESULTS Mean age and sex distribution were similar in both groups. Mean lowest postoperative corrected calcium levels in the study group were 2.19 mmol/l and 2.15 mmol/l in the control group (P = 0.24). Parathyroid auto-transplantation was associated with low PTH levels (risk ratio = 0.49). Over 50% of patients (n = 27) were successfully discharged on the first postoperative day in the study group and no patient required readmission. Length of stay was significantly shorter in the study group, mean 1.64 vs. 2.20 days (P < 0.05). CONCLUSION The use of iPTH accurately predicts hypocalcaemia after total thyroidectomy and can be used to facilitate safe early discharge for patients.
3.
Gamma probe (99m)Tc-pertechnetate assisted completion thyroidectomy vs conventional thyroidectomy in differentiated thyroid carcinoma.
Bender, O, Karyagar, S, Levent Balci, F, Yuney, E, Kamali, S, Ozpacaci, T, Mulazimoglu, M, Uyanik, E, Karyagar, SS, Sari, YS
Hellenic journal of nuclear medicine. 2009;(2):138-41
Abstract
Patients undergoing partial thyroidectomy for benign diseases may need re-operation if differentiated thyroid carcinoma (DTC) is detected on histopathology. The aim of this study was to determine if using gamma probe during the above surgery in a procedure called: gamma probe completion thyroidectomy (GPCT) could support the diagnosis of DTC tissue and offer an advantage in the surgical treatment of DTC patients. We have studied 100 patients who after bilateral subtotal thyroidectomy for benign disease in several hospitals, were found to have DTC histopathologically and referred to our clinic for subsequent re-operation. Of these, 50 underwent conventional completion thyroidectomy (Group I) and 50 underwent GPCT (Group II). We compared retrospectively Group I and Group II in terms of volume of residual thyroid tissue, thyroid stimulating hormone (TSH) values, complication rates and incidence of tumor found in the residual thyroid. Our results showed that one month postoperatively, TSH was significantly higher in Group II (P<0.001). Volumes of residual thyroid were also significantly less in Group II (P<0.000). Complications and the incidence of tumor cells found in the residual thyroid tissue between the groups were not statistically different (P>0.05). In conclusion, GPCT in patients with DTC significantly increased the success of this operation in localizing and removing residual thyroid tissue.
4.
Successful thyroid tissue ablation as defined by a negative whole-body scan or an undetectable thyroglobulin: a comparative study.
Karam, M, Feustel, PJ, Postal, ES, Cheema, A, Goldfarb, CR
Nuclear medicine communications. 2005;(4):331-6
Abstract
BACKGROUND Successful thyroid tissue ablation of patients with well-differentiated thyroid cancer can be defined by a negative whole-body scan (WBS) and/or an undetectable thyroglobulin (Tg). Variables associated with success are poorly understood. Tg measurement, although more sensitive than WBS, has not been firmly established as the sole monitoring method. In a previous study, we retrospectively evaluated the variables associated with scintigraphic success. Ablation dose (AD) was the only variable associated with success (odds ratio (OR): 1.96 per 1.85 GBq increment; 95% confidence interval (CI)=1.11-3.46). OBJECTIVES (1) To determine if the variables associated with success are the same using Tg. (2) To determine whether Tg measurement can become the sole method for assessing ablation success. METHODS We performed the analysis using a Tg level <2 ng.ml-1 as a criterion for completed ablation. Data were available from 109 patients. RESULTS Univariate analysis showed an effect of stage (OR=0.05; 95% CI=0.01-0.23) and female sex (OR=2.8; 95% CI=1.14-6.89). Multivariate analysis demonstrated only stage to be a significant predictor of success. Ablation was successful by both methods in 62/109 patients and it failed by both in 10/109. There were 21 WBS- Tg+ and 16 WBS+ Tg- patients. CONCLUSIONS Investigation of the variables associated with successful ablation yields different results depending on the definition of success. There was a significant incidence of WBS+ Tg- cases after initial ablation. Until it is firmly established that such patients have a benign course both monitoring methods should be used.