History
The first mentionof goiters in China occurs as
early as 2700 B.C.
500 that Abdul Kasan Kelebis Abis in Baghdad
performed the first recorded goiter excision.
Italy, in the 12th and 13th centuries
In 1646, Wilhelm Fabricus reported the first
thyroidectomy performed using scalpels.
1791, Pierre Joseph Desault performed a
successful partial thyroidectomy in Paris.
Guillaume Dupuytren followed in Desault’s
footsteps and in 1808 performed the first
“total”thyroidectomy.
1850s, a variety of incisions—longitudinal,
oblique, and, occasionally, Y-shaped—were
performed for thyroidectomy.
4.
conti……
Collar incision hadbeen introduced by Jules
Boeckel of Strasbourg in 1880.
After skin incisions, most surgeons at this time
performed blunt dissection. Bleeding was
generally inadequately controlled
5.
In the 1830s,Robert Graves’ and Karl von
Basedow initially described toxic diffuse goiter
through recognition of the “Merseburg triad” of
goiter, exophthalmos, and palpitations.
By the 1850s, the mortality rate following thyroid
surgery was still high, approximately 40%.
Samuel David Gross 1866
6.
1847, in Vladikavkaz,Russia, Nikolai Pirogov
was the first surgeon to use general anesthesia
during a thyroidectomy.
The introduction of antisepsis by Joseph Lister
in 1867 was the second step in the surgical
revolution.
From 1850 to 1875, mortality from thyroid
surgery was reduced by half
Theodor Kocher who stands alone in the annals
of thyroid surgery.
He reported a reduction in mortality from 12.6%
in the 1870s to 0.2% in 1898.
37.
Minimally Invasive Video-AsistedThyroidectomy
Indications
■ Multinodular goiter (thyroid volume less than 25 mL and nodules smaller
than 3 cm)
■ Low-risk papillary carcinoma
■ Graves’ disease
■ Microfollicular/Hürthle cell adenoma
■ RET gene mutation carriers (familial medullary thyroid carcinoma)
38.
continuous
Contraindications
■ Absolute
■ Previousneck surgery
■ Acute thyroiditis
■ Metastatic carcinoma (levels II to VI)
■ Locally advanced carcinoma
■ Sporadic medullary carcinoma
■ Relative
■ Previous neck irradiation
■ Short neck in an obese patient
■ Chronic thyroiditis
48.
OveRview Of ThyROidSuRgeRy COmpliCATiOnS
SummARy – Introduction: The most obvious indication for thyroid surgery is malignancy, but
other indications are also not rare. As with any other surgical procedure, those surgeries also carry risks
which can be classified as minor or major.
Discussion: in this overview, we present
minor (seroma, scarring) and
major complications of thyroid surgery (recurrent nerve injury, hypoparathyroidism, and
bleeding). we discuss the possibilities of prevention and treatment of each of those complications.
Conclusion: in recent years, thyroid surgery is becoming safer due to the development of new surgical,
hemostatic, and other techniques such as intraoperative monitoring of the recurrent laryngeal nerve
and parathyroid gland detection.
49.
September 18, 2019
Conclusionsand Relevance Use of VSDs during thyroid operations was associated with reduced odds of neck
hematoma compared with CH techniques without increasing odds of nerve injury. The results suggest that postoperative
neck hematoma rates after thyroid surgery may differ based on the hemostasis technique and that these differences should
be considered when developing strategies for quality improvement of postoperative outcom
