Active Surveillance of Thyroid Microcarcinomas: a Critical View.

Purpose Of The Review: There has been an increasing interest on active surveillance for papillary thyroid microcarcinomas (PTMC) in the literature. We will analyze the contributions of those authors who support this approach in most patients with low-risk tumors.

Recent Findings: The development of molecular methods to effectively detect aggressive PTMC at the fine-needle aspiration biopsy will enable the sound indication of immediate surgery in those patients, assuring the other individuals with the far more frequent indolent PTMC will undergo active surveillance with less anxiety.

Abdominal compression: a new intraoperative maneuver to detect chyle fistulas during left neck dissections that include level IV.

Background: Chyle fistulas may occur after left neck dissections that include level IV, due to injury of the thoracic duct or of 1 of its major branches. Despite being unusual, this complication carries substantial postoperative morbidity and even mortality. So far, no effective intraoperative maneuver has been reported to detect this fistula at the end of a neck dissection.

Negative and positive predictive values of nerve monitoring in thyroidectomy.

Background: Recurrent nerve injury is 1 of the most important complications of thyroidectomy. During the last decade, nerve monitoring has gained increasing acceptance in several centers as a method to predict and to document nerve function at the end of the operation. We evaluated the efficacy of a nerve monitoring system in a series of patients who underwent thyroidectomy and critically analyzed the negative predictive value (NPV) and positive predictive value (PPV) of the method.

Recurrent laryngeal nerve: a plexus rather than a nerve?

Objectives: To analyze the frequency of extralaryngeal branching (ELB) of the recurrent laryngeal nerve (RLN) in a consecutive series of patients undergoing thyroidectomy by the same group of surgeons during an extended period and to compare our findings with the data available in the literature.

Design: Retrospective medical record study.

Setting: Academic research.

How to minimize complications in thyroid surgery?

Background: In ancient times, operations on the thyroid gland caused unacceptable morbidity and mortality. Only after the landmark work of Kocher, the technical principles of thyroidectomy were solidly established, and are still valid nowadays.

Methods: Revision article on practical suggestions to decrease morbidity associated with thyroidectomy, as well as warning against common pitfalls that the surgeon may encounter.

Perineural invasion in aggressive skin carcinomas of the head and neck. Potentially dangerous but frequently overlooked.

Introduction: Perineural invasion is a well-recognized form of cancer dissemination. However, it has been reported only in few papers concerning cutaneous carcinomas (basal cell, BCC, and squamous cell, SCC). Moreover, the incidence is considered to be very low.

Thyroid function after unilateral total lobectomy: risk factors for postoperative hypothyroidism.

Objective: To evaluate the incidence of postoperative hypothyroidism among patients who underwent unilateral total lobectomy and identify related factors.

Design: Retrospective medical record analysis.

Setting: Oncological center and private clinic.

First-bite syndrome after resection of the styloid process.

Background: First-bite syndrome (FBS) may occur after operations on parapharyngeal space. The main symptom is excruciating pain only after the first one or two bites of meals.

Objective: The objective of this article is to report a case of FBS after resection of the styloid process (SP).

Reconstruction of upper digestive tract: reducing morbidity by laparoscopic pull-up.

Background: Gastric pull-up is a useful method for reconstruction of the upper digestive tract, with considerable morbidity/mortality, especially in esophageal cancers (EC).

Objective: To analyze the experience of a multidisciplinary team with a laparoscopic gastric pull-up (LGPU) method, with or without thoracoscopy, in a series of 120 patients with EC.

Study Design: Retrospective.

Double-bladed scalpel: a new option for harvesting margins in head and neck cancers.

Background: In advanced head and neck tumors margins are very rarely comprehensively checked by frozen sections. The goal of this study was to analyze a new proposal for harvesting margins using a double-bladed scalpel.

Methods: Thirty-eight patients underwent a comprehensive resection of advanced head and neck tumors with a double-bladed scalpel.