Clinical Updates of Thyroid Disease and Related Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Endocrinology & Metabolism".

Deadline for manuscript submissions: closed (20 July 2023) | Viewed by 9389

Special Issue Editors


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Guest Editor
Department of Surgical Sciences, Sapienza University of Rome, 00161 Rome, Italy
Interests: general surgery; oncological surgery; endocrine surgery and thyroid surgery; breast surgery

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Guest Editor
Endocrine Surgery - General Oncologic and Mini-Invasive Surgery Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
Interests: general surgery; oncological surgery; endocrine surgery; minimally invasive surgical treatment; endoscopic adrenalectomy

Special Issue Information

Dear Colleagues,

This Special Issue will highlight the current state of the art in terms of recent advances in thyroid disease, both in the benign and the malignant disease, and the related advancements in thyroid surgery.

We welcome original publications and reviews focusing on the clinical management of thyroid disease, such as the diagnosis and surveillance of patients with nodular disease, thyroid carcinomas and rare endocrine neoplasms, including genetic counseling for the personalization of diagnosis and treatment of advanced and non-advanced neoplasms, related to the progress in endocrine surgery. Over the years, new and innovative techniques have been developed, proposed and implemented in thyroid surgery; for example, endoscopic and robotic surgery and the transoral approach.

The aim of this Special Issue is to present cutting-edge and up-to-date techniques in thyroid surgery, thus setting the stage for future research and new innovative techniques in the field. We would like to hear how researchers have adapted these new technologies to their daily practices and the results of these. 

Dr. Laura Giacomelli 
Dr. Marco Boniardi
Guest Editors

Manuscript Submission Information

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Keywords

  • general surgery
  • endocrine surgery
  • oncological surgery
  • new techniques in thyroid surgery
  • early diagnosis of cancers
  • robotic thyroidectomy
  • interoperative neuromonitoring
  • parathyroid autofluorescence
  • minimally invasive parathyroidectomy

Published Papers (5 papers)

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Research

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15 pages, 323 KiB  
Article
Parathyroid Retrospective Analysis of Neoplasms Incidence (pTRANI Study): An Italian Multicenter Study on Parathyroid Carcinoma and Atypical Parathyroid Tumour
by Angela Gurrado, Alessandro Pasculli, Nicola Avenia, Rocco Bellantone, Marco Boniardi, Isabella Merante Boschin, Pietro Giorgio Calò, Michele Camandona, Giuseppe Cavallaro, Fabio Cianchi, Giovanni Conzo, Vito D’Andrea, Carmela De Crea, Loredana De Pasquale, Paolo Del Rio, Giovanna Di Meo, Gianlorenzo Dionigi, Chiara Dobrinja, Giovanni Docimo, Fausto Famà, Attilio Galimberti, Laura Giacomelli, Giuseppa Graceffa, Maurizio Iacobone, Nadia Innaro, Celestino Pio Lombardi, Gabriele Materazzi, Fabio Medas, Barbara Mullineris, Luigi Oragano, Nicola Palestini, Giuliano Perigli, Angela Pezzolla, Francesco Paolo Prete, Marco Raffaelli, Giuseppina Renzulli, Lodovico Rosato, Gregorio Scerrino, Lucia Ilaria Sgaramella, Salvatore Sorrenti, Carlotta Testini, Massimiliano Veroux, Guido Gasparri, Mario Testini and pTRANI Study Groupadd Show full author list remove Hide full author list
J. Clin. Med. 2023, 12(19), 6297; https://doi.org/10.3390/jcm12196297 - 29 Sep 2023
Cited by 3 | Viewed by 1510
Abstract
Background: Parathyroid cancer (PC) is a rare sporadic or hereditary malignancy whose histologic features were redefined with the 2022 WHO classification. A total of 24 Italian institutions designed this multicenter study to specify PC incidence, describe its clinical, functional, and imaging characteristics and [...] Read more.
Background: Parathyroid cancer (PC) is a rare sporadic or hereditary malignancy whose histologic features were redefined with the 2022 WHO classification. A total of 24 Italian institutions designed this multicenter study to specify PC incidence, describe its clinical, functional, and imaging characteristics and improve its differentiation from the atypical parathyroid tumour (APT). Methods: All relevant information was collected about PC and APT patients treated between 2009 and 2021. Results: Among 8361 parathyroidectomies, 351 patients (mean age 59.0 ± 14.5; F = 210, 59.8%) were divided into the APT (n = 226, 2.8%) and PC group (n = 125, 1.5%). PC showed significantly higher rates (p < 0.05) of bone involvement, abdominal, and neurological symptoms than APT (48.8% vs. 35.0%, 17.6% vs. 7.1%, 13.6% vs. 5.3%, respectively). Ultrasound (US) diameter >3 cm (30.9% vs. 19.3%, p = 0.049) was significantly more common in the PC. A significantly higher frequency of local recurrences was observed in the PC (8.0% vs. 2.7%, p = 0.022). Mortality due to consequences of cancer or uncontrolled hyperparathyroidism was 3.3%. Conclusions: Symptomatic hyperparathyroidism, high PTH and albumin-corrected serum calcium values, and a US diameter >3 cm may be considered features differentiating PC from APT. 2022 WHO criteria did not impact the diagnosis. Full article
(This article belongs to the Special Issue Clinical Updates of Thyroid Disease and Related Surgery)
11 pages, 273 KiB  
Article
Risk Factors for Hypoparathyroidism after Thyroid Surgery: A Single-Center Study
by Francesca Privitera, Danilo Centonze, Sandro La Vignera, Rosita Angela Condorelli, Costanza Distefano, Rossella Gioco, Alba Ilari Civit, Giordana Riccioli, Ludovica Stella, Andrea Cavallaro, Matteo Angelo Cannizzaro and Massimiliano Veroux
J. Clin. Med. 2023, 12(5), 1956; https://doi.org/10.3390/jcm12051956 - 1 Mar 2023
Cited by 3 | Viewed by 1580
Abstract
Background: Hypoparathyroidism is one of the most common complications after thyroidectomy. This study evaluated the incidence and potential risk factors for postoperative hypoparathyroidism after thyroid surgical procedures in a single high-volume center. Methods: In this retrospective study, in all patients undergoing thyroid surgery [...] Read more.
Background: Hypoparathyroidism is one of the most common complications after thyroidectomy. This study evaluated the incidence and potential risk factors for postoperative hypoparathyroidism after thyroid surgical procedures in a single high-volume center. Methods: In this retrospective study, in all patients undergoing thyroid surgery from 2018 to 2021, a 6 h postoperative parathyroid hormone level (PTH) was evaluated. Patients were divided into two groups based on 6 h postoperative PTH levels (≤12 and >12 pg/mL). Results: A total of 734 patients were enrolled in this study. Most patients (702, 95.6%) underwent a total thyroidectomy, while 32 patients underwent a lobectomy (4.4%). A total of 230 patients (31.3%) had a postoperative PTH level of <12 pg/mL. Postoperative temporary hypoparathyroidism was more frequently associated with female sex, age < 40 y, neck dissection, the yield of lymph node dissection, and incidental parathyroidectomy. Incidental parathyroidectomy was reported in 122 patients (16.6%) and was correlated with thyroid cancer and neck dissection. Conclusions: Young patients undergoing neck dissection and with incidental parathyroidectomy have the highest risk of postoperative hypoparathyroidism after thyroid surgery. However, incidental parathyroidectomy did not necessarily correlate with postoperative hypocalcemia, suggesting that the pathogenesis of this complication is multifactorial and may include an impaired blood supply to parathyroid glands during thyroid surgery. Full article
(This article belongs to the Special Issue Clinical Updates of Thyroid Disease and Related Surgery)
8 pages, 255 KiB  
Article
The Use of Harmonic Focus and Thunderbeat Open Fine Jaw in Thyroid Surgery: Experience of a High-Volume Center
by Gian Luigi Canu, Fabio Medas, Federico Cappellacci, Francesco Casti, Raffaela Bura, Enrico Erdas and Pietro Giorgio Calò
J. Clin. Med. 2022, 11(11), 3062; https://doi.org/10.3390/jcm11113062 - 29 May 2022
Cited by 5 | Viewed by 1559
Abstract
Background: In thyroid surgery, achieving accurate haemostasis is fundamental in order to avoid the occurrence of complications. Energy-based devices are currently extensively utilized in this field of surgery. This study aims to compare Harmonic Focus and Thunderbeat Open Fine Jaw with regard to [...] Read more.
Background: In thyroid surgery, achieving accurate haemostasis is fundamental in order to avoid the occurrence of complications. Energy-based devices are currently extensively utilized in this field of surgery. This study aims to compare Harmonic Focus and Thunderbeat Open Fine Jaw with regard to surgical outcomes and complications. Methods: Patients submitted to total thyroidectomy in our center, between January 2017 and June 2020, were retrospectively analysed. Based on the energy-based device utilized, two groups were identified: Group A (Harmonic Focus) and Group B (Thunderbeat Open Fine Jaw). Results: A total of 527 patients were included: 409 in Group A and 118 in Group B. About surgical outcomes, the mean operative time was significantly shorter in Group B than in Group A (p < 0.001), while as regards complications, the occurrence of transient recurrent laryngeal nerve injury was significantly greater in Group B than in Group A (p = 0.019). Conclusions. Both Harmonic Focus and Thunderbeat Open Fine Jaw have proven to be effective devices. Operative times were significantly shorter in thyroidectomies performed with Thunderbeat Open Fine Jaw; however, the occurrence of transient recurrent laryngeal nerve injury was significantly greater in patients operated on with this device. Full article
(This article belongs to the Special Issue Clinical Updates of Thyroid Disease and Related Surgery)

Review

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12 pages, 1121 KiB  
Review
Ultrasound-Guided Ethanol Ablation for Thyroglossal Duct Cyst: A Review of Technical Issues and Potential as a New Standard Treatment
by Dongbin Ahn
J. Clin. Med. 2023, 12(17), 5445; https://doi.org/10.3390/jcm12175445 - 22 Aug 2023
Viewed by 1737
Abstract
The thyroglossal duct cyst (TGDC) is the most common congenital neck mass, accounting for 70–75% of all congenital neck masses. Although the Sistrunk operation has been used as a standard of treatment, it is accompanied by a considerable surgical burden, including the need [...] Read more.
The thyroglossal duct cyst (TGDC) is the most common congenital neck mass, accounting for 70–75% of all congenital neck masses. Although the Sistrunk operation has been used as a standard of treatment, it is accompanied by a considerable surgical burden, including the need for general anesthesia, a visible surgical scar on the neck surface, and postoperative complications. Ultrasound-guided ethanol ablation (US-EA) is a minimally invasive and office-based technique that is widely used as a non-surgical treatment for several benign cystic lesions, particularly benign thyroid cysts. Recently, US-EA has also been gaining popularity as a good alternative for TGDC treatment, which is associated with high feasibility, a high safety profile, and favorable treatment outcomes. To our best knowledge, seven studies on the use of EA as a primary treatment option for TGDC have been published since 2011. Although these studies have reported promising results, there is a lack of consensus on several issues regarding the application of EA for TGDC, particularly its detailed techniques and role as a primary treatment. This article aims to provide a comprehensive review of EA for TGDC, addressing technical issues and its possible role as a new standard of treatment for TGDC. Full article
(This article belongs to the Special Issue Clinical Updates of Thyroid Disease and Related Surgery)
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15 pages, 2440 KiB  
Review
Association of Hypothyroidism and the Risk of Cognitive Dysfunction: A Meta-Analysis
by Yuanyuan Ye, Yiqing Wang, Shiwei Li, Jiyun Guo, Li Ding and Ming Liu
J. Clin. Med. 2022, 11(22), 6726; https://doi.org/10.3390/jcm11226726 - 14 Nov 2022
Cited by 5 | Viewed by 2099
Abstract
Objectives: The purpose of this meta-analysis was to assess whether there is an association between hypothyroidism and the risk of cognitive dysfunction. Methods: PubMed, Cochrane Library, and Embase were searched for relevant studies published from database inception to 4 May 2022, using medical [...] Read more.
Objectives: The purpose of this meta-analysis was to assess whether there is an association between hypothyroidism and the risk of cognitive dysfunction. Methods: PubMed, Cochrane Library, and Embase were searched for relevant studies published from database inception to 4 May 2022, using medical subject headings (MeSHs) and keywords. Results: Eight studies involving 1,092,025 individuals were included, published between 2010 and 2021. The pooled analysis showed that there was no association between hypothyroidism and cognitive dysfunction (OR = 1.13, 95% CI = 0.84–1.51, p = 0.426), including both all-cause dementia (OR = 1.04, 95% CI = 0.76–1.43, p = 0.809) and cognitive impairment (OR = 1.50, 95% CI = 0.68–3.35, p = 0.318). Neither overt hypothyroidism (OR = 1.19, 95% CI = 0.70–2.02, p = 0.525) nor subclinical hypothyroidism (OR = 1.04, 95% CI = 0.73–1.48, p = 0.833) was associated with cognitive dysfunction. Neither prospective cohort (OR = 1.08, 95% CI = 0.77–1.51, p = 0.673) nor cross-sectional studies (OR = 1.23, 95% CI = 0.63–2.42, p = 0.545) had any effect on the association. Interestingly, the risk of cognitive dysfunction was significantly increased in the group not adjusted for vascular comorbidity (OR = 1.47, 95% CI = 1.07–2.01, p = 0.017), while it was reduced in the adjusted group (OR =0.82, 95% CI = 0.79–0.85, p < 0.001). Conclusions: This meta-analysis shows that hypothyroidism was associated with a reduced risk of cognitive dysfunction after adjustment for vascular-disease comorbidities. More prospective observational studies are needed in the future to investigate the relationship between hypothyroidism and cognitive dysfunction. Full article
(This article belongs to the Special Issue Clinical Updates of Thyroid Disease and Related Surgery)
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