Thyroidectomy with energy-based devices: surgical outcomes and complications-comparison between Harmonic Focus, LigaSure Small Jaw and Thunderbeat Open Fine Jaw.

Background: Being the thyroid gland a highly vascularized organ, achieving a meticulous hemostasis is essential to avoid serious complications. Currently, energy-based devices are widely used in thyroid surgery. The aim of this study was to compare Harmonic Focus (HF), LigaSure Small Jaw (LSJ) and Thunderbeat Open Fine Jaw (TB) in terms of surgical outcomes and complications.

Surgery for primary hyperparathyroidism in patients with preoperatively negative sestamibi scan and discordant imaging studies: the usefulness of intraoperative parathyroid hormone monitoring.

The aim of this study was to evaluate the impact of intraoperative parathyroid hormone (PTH) monitoring on surgical strategy, intraoperative findings, and outcome in patients with negative sestamibi scintigraphy and with discordant imaging studies. We divided our 175 patients into 3 groups: group A was methoxyisobutylisonitrile (MIBI)-positive and ultrasonography positive and was concordant (114 patients), group B was MIBI-positive and ultrasonography-negative (50 patients), and group C was MIBI-and ultrasonography-negative (11 patients). The overall operative success was 99.

Cervical lymph node sarcoidosis mimicking a parathyroid adenoma: a clinical case.

We report a case of cervical lymph node sarcoidosis misdiagnosed as parathyroid adenoma. This is the second case described in the literature in which lymph node sarcoidosis was misdiagnosed as parathyroid adenoma on Tc-99m sestamibi (MIBI) scan, the first case localized in the neck. A 64-year-old woman presented with a hypercalcemia.

Laparoscopic lymph node biopsy in the diagnosis of lymphoma. Indications and results.

Background: Exclusive abdominal nodal involvement due to Hodgkin or non Hodgkin lymphoma (HL,NHL) is a rare condition, but its occurrence requires a good enough specimen for diagnosis and therapy. Aim of this work is to evaluate the results of laparoscopic lymph node biopsy (LLNB) in a series of patients where a primitive or relapsing lymphoma was suspected.

Methods: This study has been carried on the patients submitted to LLNB from 2007 to 2011.

Forgotten goiter. Our experience and a review of the literature.

"Forgotten" goiter is an extremely rare disease which is defined as a mediastinal thyroid mass found after total thyroidectomy. The authors report their experience of 7 cases of residual mediastinal goiter after total thyroidectomy for substernal goiter. Six patients were female and one male with a median age of 56 years (range: 25-70 years).

The use of the harmonic scalpel in thyroid surgery. Our experience.

The aim of this study was to evaluate the potential advantages of the use of Harmonic Scalpel in thyroidectomies in terms of operative time and complications. Between May 2007 and June 2010 1151 patients were submitted to total thyroidectomy. In 681 thyroidectomies were performed using harmonic scalpel FOCUS (group A), in 470 without it (group B).

Postoperative hematomas after thyroid surgery. Incidence and risk factors in our experience.

Aim: The aim of our study was to evaluate the incidence and timing of postoperative bleeding and to identify the potential aetiological factors of cervical hematomas complicating thyroid surgery.

Material: Between September 2002 and December 2009, 2559 patients were operated on in Department of Surgery, University Hospital of Cagliari. 2257 total thyroidectomies, 191 total thyroidectomies associated to lymphadenectomy, 83 total thyroidectomies associated to parathyroidectomy, 24 thyroid lobectomies and 4 lobectomies associated to parathyroidectomy were performed.

[Recurrent goitre: our experience].

Recurrence after conservative thyroid surgery ranges from 7 to 40%. Risk factors for recurrence are female sex, multiple nodules in the resected lobe and lack of postoperative LT4 therapy. Indications for reoperation are suspected malignancy, recurrent thyrotoxicosis and recurrent uninodular or multinodulare goitre.

Adult idiopathic intussusception: a case report and review of the literature.

Adult intussusception is a rare condition. Most of the cases are due to an organic lesion and unlike the incidence in children idiopathic forms are really exceptional, occurring at a rate of 5% of all cases. Whereas in children a main cause is seldom found, adult intussusception is usually characterised by the presence of a leading intraluminal benign or malignant lesion.

Surgical gastrostomy when percutaneous endoscopic gastrostomy is not feasible: indications, results and comparison between the two procedures.

Percutaneous endoscopic gastrostomy (PEG) is the procedure of choice in patients unable to eat owing to neoplastic or neurological diseases. In a few cases, however, PEG is not feasible and on such occasions a surgical gastrostomy (SG) proves mandatory to prevent starvation. The aim of the present study was to evaluate the cases submitted to SG when PEG could not be performed and to compare the results of the two procedures.

Hydatid cyst of trapezius muscle: an unusual localisation. Report of a case and review of the literature.

The muscular localisation of hydatid cyst is very uncommon. The authors report a recently observed case of hydatid cyst of the trapezius muscle. An 81-year-old man presented with a 9-months history of a slow-growing painless mass in his left shoulder associated with itching.

[Length of hospital stay and complications in thyroid surgery. Our experience].

Length of hospital stays for thyroid surgery has decreased significantly over the last years. Hypoparathyroidism is one of the main obstacles to short-stay hospitalization. The aim of this study was to evaluate length of hospital stay in our experience, its relationship with complications observed and feasibility of short-stay hospitalization regimen.

[Emergencies in thyroid surgery. Our experience].

The rate of complications after thyroid surgery is about 5% and among these real emergencies account for less than 1%, consisting in intraoperative and postoperative bleeding, bilateral recurrent palsy, severe hypoparathyroidism and, rarely, laryngeal oedema and tracheomalacia. Between 2000 and 2004 849 patients were submitted to total thyroidectomy for various thyroid pathologies in our institution. Complications observed were postoperative bleeding in 13 patients (1.

[Substernal goiter: personal experience].

Aim Of The Study: The Authors report on their experience in the surgical treatment of substernal goiter.

Material And Methods: Between 1972 and 2004, 222 patients with substernal goiters were observed among 2720 patients undergoing surgical treatment for various thyroid diseases (8.16%).

[Differentiated thyroid carcinoma and hyperthyroidism: a frequent association?].

The relationship between hyperthyroidism and thyroid carcinoma remains controversial. In hyperthyroid patients the incidence of thyroid cancer varies considerably from 0.1% to 21%.