• Title/Summary/Keyword: thyroidectomy

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Factors Influencing the quality of life in thyroid cancer patients after thyroidectomy (갑상선암 수술환자의 삶의 질에 영향을 미치는 요인)

  • Jeong, Jeong-Sook;Kim, In-Sook;Lee, Eun-Seon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.8
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    • pp.5442-5451
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    • 2015
  • The purpose of this study was to examine the affection factors of quality of life in thyroid cancer patients after thyroidectomy. The subject of this study were 125 patients with thyroid cancer who were receiving operation and outpatient medical examination in general hospital in Gwangju city. Data were analysed using descriptive statistics, t-test, one-way ANOVA, Sheffe test, Pearson correlation analysis and stepwise multiple regression analysis using SPSS 21.0 program. The significant factors influencing quality of life were depression(${\beta}=-0.39$, p<.001), spiritual fatigue(${\beta}=-0.30$, p<.001) and physical fatigue(${\beta}=-0.24$, p<.001), which explained 57.2% of the quality of life. Therefore, it is necessary to develop nursing intervention program reducing fatigue and depression for thyroid cancer patients after thyroidectomy.

The Clinical Analysis of Medullary Thyroid Carcinoma : 10 Cases (갑상선 수질암 10례의 임상적 분석)

  • Kim Sang-Hyun;No Ho-Sang;Moon Jun-Hwan;Kim Jung-Su;Hwang Dong-Jo;Seo Jeong-Min
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.2
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    • pp.222-225
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    • 1999
  • Background and Objectives: Medullary thyroid carcinoma(MTC) is a rare tumor derived from the parafollicular C cells of the thyroid gland accounting for 5-10% of all thyroid malignancies. In Korea, there has been a few case report of medullary thyroid carcinoma(MTC) but their clinical analysis were not exactly studied. So, we made clinical study of 10 patients diagnosed as medullary thyroid carcinoma. Materials and Methods: We reviewed clinical data of 10 patients who were diagnosed as medullary thyroid carcinoma(MTC) from April 1973 to August 1998 at National Medical Center. Results: The incidence of MTC was 2.3% of all thyroid cancer and their mean age were 44.2 years old. Preoperative thyroid scan showed cold nodule in all patients and thyroid function test(TFT) was within normal range. Of the 10 patents, only 4 patients had diagnosis of MTC in preoperative fine needle aspiration biopsy. All the patients underwent total thyroidectomy with central neck dissection. Two patients with cervical lymph node metastasis underwent total thyroidectomy, central neck dissection and modified neck dissection. Two patients (20%) showed recurrence at the site of neck, lung, mediastinum, bone and liver. Conclusion: Most MTC is sporadic form and have peak incidence in the fifth decade and female preponderance. Preoperative fine needle aspiration biopsy is considered to be a clinically useful diagnostic method, but its accuracy is not considered as much high as others. Total thyroidectomy with central neck dissection may be an useful surgical modality in treating medullary thyroid carcinoma.

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Efficacy of Intraoperative Neural Monitoring (IONM) in Thyroid Surgery: the Learning Curve (갑상선 수술에서 수술 중 신경 감시의 효용성: 학습곡선을 중심으로)

  • Kwak, Min Kyu;Lee, Song Jae;Song, Chang Myeon;Ji, Yong Bae;Tae, Kyung
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.130-136
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    • 2018
  • Background and Objectives: Intraoperative neural monitoring (IONM) of recurrent laryngeal nerve (RLN) in thyroid surgery has been employed worldwide to identify and preserve the nerve as an adjunct to visual identification. The aims of this study was to evaluate the efficacy of IONM and difficulties in the learning curve. Materials and Methods: We studied 63 patients who underwent thyroidectomy with IONM during last 2 years. The standard IONM procedure was performed using NIM 3.0 or C2 Nerve Monitoring System. Patients were divided into two chronological groups based on the success rate of IONM (33 cases in the early period and 30 cases in the late period), and the outcomes were compared between the two groups. Results: Of 63 patients, 32 underwent total thyroidectomy and 31 thyroid lobectomy. Failure of IONM occurred in 9 cases: 8 cases in the early period and 1 case in the late period. Loss of signal occurred in 8 nerves of 82 nerves at risk. The positive predictive value increased from 16.7% in the early period to 50% in the late period. The mean amplitude of the late period was higher than that of the early period (p<0.001). Conclusion: IONM in thyroid surgery is effective to preserve the RLN and to predict postoperative nerve function. However, failure of IONM and high false positive rate can occur in the learning curve, and the learning curve was about 30 cases based on the results of this study.

Is Completion Thyroidectomy Necessary in Patients with Papillary Thyroid Carcinoma who Underwent Lobectomy? (엽절제술을 시행한 갑상선 유두암 환자에서 완결 갑상선 절제술이 필요한지에 대한 연구)

  • Kang, Il Ku;Kim, Kwangsoon;Bae, Ja Seong;Kim, Jeong Soo
    • Korean Journal of Head & Neck Oncology
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    • v.37 no.2
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    • pp.25-31
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    • 2021
  • Background/Objectives: Although thyroid lobectomy recently is considered as sufficient for low-risk papillary thyroid carcinoma (PTC), completion thyroidectomy is required due to the insufficiency of the preoperative evaluation. The aim of this study was to investigate recurrence rate and disease free survival depending on the gross extrathyroidal extension (gETE) or the number of metastatic lymph node identified in patients with PTC. Materials & Methods: We assessed 3373 patients with PTC who underwent lobectomy at Seoul St. Mary's Hospital (Seoul, Korea) between January 2009 and December 2014. Clinicopathological characteristics and long-term surgical outcomes were retrospectively analyzed through complete chart reviews. The mean follow-up duration was 97.1 ± 21.4 months. Results: The rate of recurrence was higher in gETE group (1.8% vs. 6.0%, p=0.004), leading to decreased disease free survival in Kaplan-Meier analysis (log-rank p<0.001). N1 group (n=1389) was analyzed into two groups whether the number of positive nodes is more than 5 or less. For the group of the more metastatic nodes, the recurrence rate higher compared to the other group (3.0% vs. 9.3%, p<0.001). DFS was longer in the group that had lesser metastatic nodes (log-rank p<0.001). However, in terms of N1 group over 1cm (n=492), No statistical difference was observed according to the number of positive lymph nodes (4.5% vs. 9.1%, p=0.092) Conclusion: When it comes to node positive PTC, Despite the number of positive lymph nodes was over 5, follow-up with no further surgery can be an option.

Botulinum Toxin A Treatment for Cervical Dystonia Resulting in Endoscopic Thyroidectomy: A Case Report (내시경 갑상샘 절제술 후 발생한 경부 근긴장이상증의 보툴리늄 A 독소를 이용한 치료: 증례보고)

  • Oh, Hwa-Young;Choi, Hwan-Jun;Nam, Doo-Hyun;Kim, Jun-Hyuk;Lee, Young-Man
    • Archives of Plastic Surgery
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    • v.38 no.2
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    • pp.207-211
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    • 2011
  • Purpose: Surgery for thyroid gland requires skin incisions that can result in postsurgical neck scar. To overcome this, many surgeons performed a endoscopic thyroidectomy. But, this approach had a some problems. One of postoperative problems, iatrogenic cervical dystonia (CD) may occur. At common, CD is defined as a syndrome characterized by prolonged muscle contraction causing twisting, repetitive movements or abnormal posture. Botulinum toxin A (BTA, Botox$^{(R)}$, Allergan, Irvine, CA, USA) is well known treatment agent in the treatment of CD. So, the authors applied BTA injection in rare case with iatrogenic CD resulting in endoscopic thyroidectomy. Methods: A 43-year-old female had endoscopic subtotal thyroidectomy operation 3 years ago. She had symptoms such as progressive cervical pain, abnormal neck posture, depression, and sleep difficulty. About 1 year later, the patient who had previous myomectomy of the clavicular head of sternocleidomastoid muscle, however, symptoms were not improved. And then the patient received BTA therapy in our department. The 2 units per 0.1 mL solution was administered in a 1 mL tuberculin syringe. Results: The dose of BTA used in the patient was 36 units for vertical platysmal bands, superficially, and 10 units for ipsilateral sternocleidomastoid muscle, intramuscularly. After 2 weeks, additional the dose of BTA used in the patient was 5 points for remained scar bands, superficially. Complications related to injection such as significant swallowing difficulties, neck muscle weakness, or sensory change were not observed. In 9 months follow-up, the patient maintained a good result from the method of BTA injection alone. Conclusion: The basic concept is selective denervation for the hyperactive individual muscles and scar bands. We conclude that BTA is an effective and safe treatment for CD despite the iatrogenic and complex presentation of this complication.

Warthin-Like Tumor of Thyroid Gland : A Case Report (갑상선의 Warthin 모양 종양 1예)

  • Kwon Ki-Hwan;Yoon Jong-Ho;Hong Soon-Won;Koo Ja-Seung;Chung Woung-Youn;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.20 no.1
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    • pp.33-36
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    • 2004
  • Papillary carcinoma of thyroid is the most common thyroid carcinoma carrying better prognosis than the other thyroid carcinoma. Among the variants in the papillary thyroid carcinoma, the tall cell variant and diffuse sclerosing variants have more aggressive behavior than the classic papillary carcinoma. Recently, a new variant of papillary carcinoma has been reported which was named warthin-like tumor of the thyroid because of its close histologic resemblance to a tumor encountered in the salivary gland, carrying favorable prognosis. Since then, in English literature, a few cases have been reported, but in Korea have not been reported yet. We report a case of warthin-like tumor of the thyroid. A 38 year-old woman who had neck mass, was administered for thyroid surgery due to suspicious thyroid cytology. Right total thyroidectomy and left subtotal thyroidectomy with central compartment node dissection was performed. Histologic diagnosis was made as a Warthin-like tumor of the thyroid.

A Case of Tracheal Necrosis after Total Thyroidectomy and Mediastinal Dissection (갑상선 전절제술 및 종격동 청소술 시행 후 발생한 기관 괴사 치험 1예)

  • Rho Young-Soo;Kim Jin-Hwan;Han Dong-Hyuk;Kim Eung-Jung;Jung Chul-Hoon
    • Korean Journal of Head & Neck Oncology
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    • v.20 no.1
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    • pp.58-61
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    • 2004
  • Lymph node metastasis of thyroid cancer occurs to anterior compartment (level VI) and superior mediastinal lymph node (Level VII). In lateral neck, it occurs commonly in middle and lower jugular lymph node (level III, IV). And it can also metastasis to posterior neck lymph node (level V). Superior mediastinal lymph node metastasis of thyroid cancer requires superior mediastinal dissection with massive removal of peritracheal and periesophageal soft tissue. After superior mediastinal dissection, severe complication may occurs such as innominate artery rupture and tracheal necrosis. We describe a case of tracheal necrosis as a complication of superior mediastinal dissection and total thyroidectomy in thyroid cancer patient.

There is no Gradient of TSH Receptor Antibody Activity Between Thyroidal and Peripheral Venous Blood in Patients with Graves' Disease, Undergoing Subtotal Thyroidectomy, Prepared with Antithyroid Drugs (항갑상선제로 치료받은 Graves병 환자에서 수술시 갑상선 정맥혈과 말초정맥혈간에 TSH 수용체항체의 활성도에는 차이가 없다)

  • Koh, Chang-Soon;Shong, Young-Kee;Cho, Bo-Youn;Koong, Sung-Soo;Lee, Myung-Hae;Lee, Myung-Chul;Oh, Seung-Keun
    • The Korean Journal of Nuclear Medicine
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    • v.22 no.2
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    • pp.171-174
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    • 1988
  • Thyrotropin binding inhibitory immunoglobulin (TBII) and thyroid stimulating antibody (TSAb) activities were measured in the thyroidal and peripheral venous blood samples at the time of subtotal thyroidectomy from twenty one patients with Graves' disease prepared for surgery with antithyroid drugs. There was no difference in TBII and TSAb activities between thyroidal and peripheral blood samples. These findings were regarded that while intrathyroidal lymphocytes are major site of thyrotropin receptor antibody (TRAb) production, similar levels are found in thyroidal and peripheral veins and that this in vivo study cannot exactly ascertain the TRAb producing site.

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