Opioid-Free Thyroid and Parathyroid Operations: Are Patients Satisfied With Pain Control?

Background: The aim of this study was to evaluate pain control and patient satisfaction using an opioid-free analgesic regimen following thyroid and parathyroid operations.

Methods: Surveys were distributed to all postoperative patients following total thyroidectomy, thyroid lobectomy, and parathyroidectomy between January and April 2020. After surgery, patients were discharged without opioids except in rare cases based on patient needs and surgeon judgment.

Parathyroidectomy for Tertiary Hyperparathyroidism: A Multi-Institutional Analysis of Outcomes.

Background: Patients with tertiary hyperparathyroidism (HPT) often experience delays between diagnosis and referral for surgical treatment. We hypothesized that patients with tertiary HPT experience similarly high cure rates and low complication rates after parathyroidectomy compared with patients with primary HPT.

Methods: We retrospectively identified patients undergoing parathyroidectomy from the Collaborative Endocrine Surgery Quality Improvement Program for primary or tertiary HPT from January 2014 to April 2019.

Implementation of Opioid-Free Thyroid and Parathyroid Procedures: A Single Center Experience.

Background: Initial opioid exposure for most individuals with substance use disorder comes from the healthcare system, and overprescription of opioids in ambulatory operations is common. This report describes an academic medical center's experience implementing opioid-free thyroid and parathyroid operations.

Materials And Methods: This is a retrospective chart review of patients undergoing a thyroid or parathyroid operation before and after implementation of an opioid-free analgesia protocol.

Variation in the Quality of Thyroid Nodule Evaluations Before Surgical Referral.

Background: Thyroid nodules are highly prevalent, and owing to their malignant potential, proper evaluation is imperative. The objective of this study was to characterize variation in thyroid nodule evaluations.

Materials And Methods: This retrospective review included all consecutive surgical referrals for thyroid nodules from October to December 2017 at a single institution.

Risk of Recurrence in Differentiated Thyroid Cancer: A Population-Based Comparison of the 7th and 8th Editions of the American Joint Committee on Cancer Staging Systems.

Background: Differentiated thyroid cancer (DTC) survival is excellent, making recurrence a more clinically relevant prognosticator. We hypothesized that the new American Joint Committee on Cancer (AJCC) 8th edition improves on the utility of the 7th edition in predicting the risk of recurrence in DTC.

Methods: A population-based retrospective review compared the risk of recurrence in patients with DTC according to the AJCC 7th and 8th editions using the Surveillance, Epidemiology, and End Results-based Kentucky Cancer Registry from 2004 to 2012.

Necrotizing Fasciitis of the Breast Requiring Emergent Radical Mastectomy.

Necrotizing fasciitis is a rare, aggressive, soft-tissue infection that results in necrosis of skin, subcutaneous tissue, and fascia. It spreads rapidly and may progress to sepsis, multi-organ failure, and death. Predisposing conditions include diabetes, chronic alcoholism, advanced age, vascular disease, and immunosuppression and many cases are preceded by an injury or invasive procedure.

Esophageal fistula complicating thyroid lobectomy.

Thyroidectomy is associated with low morbidity and mortality. Esophageal perforation following thyroidectomy has been reported only three times previously, with subsequent fistulization occurring in two of these cases. The authors present the first such case report in the English-speaking literature.

Preoperative laryngoscopy in thyroid surgery: Do patients' subjective voice complaints matter?

Background: Although routine preoperative laryngoscopy has been standard practice for many thyroid surgeons, there is recent literature that supports selective laryngoscopy. We hypothesize that patients' preoperative voice complaints do not correlate well with abnormalities seen on preoperative laryngoscopy.

Methods: A retrospective chart review of a 3-year, single-surgeon experience was performed.

Surgeon-driven thyroid interrogation of patients presenting with primary hyperparathyroidism.

Background: Primary hyperparathyroidism (pHPT) is an increasingly prevalent disease affecting all age groups. The authors sought to determine the impact of a "thyroid interrogation" practice protocol on the surgical treatment of patients with the diagnosis of pHPT referred to a single surgeon.

Study Design: We performed a retrospective review of prospectively gathered data on parathyroidectomy (PTX) patients undergoing both a prospective clinical thyroid evaluation and thyroid ultrasound between January 2008 and October 2012.

Intrapericardial parathyroid adenoma†.

Primary hyperparathyroidism from a parathyroid adenoma is common. Ectopic parathyroid glands have been reported in numerous locations, including the chest. We present a single case report of an intrapericardial parathyroid gland found after failed bilateral neck exploration.

Disparity between tissue and serum calcitonin and carcinoembryonic antigen in a patient with medullary thyroid carcinoma.

Medullary thyroid carcinoma (MTC) is a neuroendocrine tumor of parafollicular or C-cells of thyroid that comprises 5-10% of all thyroid cancers [1, 2]. The neoplastic cells secrete calcitonin, carcinoembryonic antigen (CEA), and chromogranin A. Typically, increased serum levels of these tumor markers permit them to be used for initial diagnosis and long-term disease status surveillance.

Cancer pain education for medical students: the development of a short course on CD-ROM.

Objective: The purpose of this study was to assess the educational value and acceptability of a short CD-ROM course on cancer pain management given to third-year medical students at the University of Kentucky.

Methods: Thirty-six medical students were given a short-course CD-ROM on cancer pain assessment and management. The Cancer Pain CD-ROM included textual instruction as well as video clips and a 15-item interactive self-assessment examination on cancer pain management.

Equipping medical students to manage cancer pain: a comparison of three educational methods.

A Cancer Pain Structured Clinical Instruction Module (SCIM), with skills stations incorporating actual cancer patients, has been developed to enhance cancer pain education among our medical students. The Cancer Pain SCIM has not been compared with more traditional cancer pain education, thus the purpose of this study was to assess the effectiveness and durability of three educational methods for teaching cancer pain management to medical students compared with a control group. Four consecutive rotations of 32 third-year medical students participated in one of four cancer pain educational strategies: 1) control group with no formal cancer pain education, 2) CD-ROM self-instruction module on cancer pain, 3) a 2-hour Cancer Pain SCIM plus the CD-ROM information, and 4) Cancer Pain SCIM, plus CD-ROM, plus a structured home-hospice patient visit.

Enhancing the clinical skills of surgical residents through structured cancer education.

Objective: To assess the short and long-term educational value of a highly structured, interactive Breast Cancer Structured Clinical Instruction Module (BCSCIM).

Summary Background Data: Cancer education for surgical residents is generally unstructured, particularly when compared with surgical curricula like the Advanced Trauma Life Support (ATLS) course.

Methods: Forty-eight surgical residents were randomly assigned to 1 of 4 groups.