Diagnosis and treatment of primary thyroid lymphoma from a surgical perspective: a multi-institutional study.

Purpose: Surgery of primary thyroid lymphoma (PTL) has been mostly limited to diagnostic work-up. This study aimed to further study its potential role.

Methods: This was a retrospective study from a multi-institutional registry of PTL patients.

Efficacy and safety of preoperative preparation with Lugol's iodine solution in euthyroid patients with Graves' disease (LIGRADIS Trial): Study protocol for a multicenter randomized trial.

Background: Currently, both the American Thyroid Association and the European Thyroid Association recommend preoperative preparation with Lugol's Solution (LS) for patients undergoing thyroidectomy for Graves' Disease (GD), but their recommendations are based on low-quality evidence. The LIGRADIS trial aims to provide evidence either to support or refute the systematic use of LS in euthyroid patients undergoing thyroidectomy for GD.

Methods: A multicenter randomized controlled trial will be performed.

Clinical Pathway for Thyroidectomy.

Clinical pathways are care plans applicable to patient care procedures that present variations in practice and a predictable clinical course. They are designed not as a substitute for clinical judgment, but rather as a means to improve the effectiveness and efficiency of the procedures. This clinical pathway is the result of a collaborative work of the Sections of Endocrine Surgery and Quality Management of the Spanish Association of Surgeons.

Best approach for posterior mediastinal goiter removal: transcervical incision and lateral thoracotomy.

Surgical removal of intrathoracic goiter can be performed by a cervical approach in the majority of patients. Review of literature shows that experienced surgeons need to perform an extracervical approach in 2-3% of cases. In spite of surgical management of substernal goiter is well defined, there is little available information about surgical approach of intrathoracic goiters extending beyond the aortic arch into the posterior mediastinum.

Isthmectomy: a conservative operation for solitary nodule of the thyroid isthmus.

Purpose: To assess the results obtained in patients with nontoxic uninodular goiter confined to the isthmus undergoing isthmectomy.

Methods: Between April 1994 and June 2006, 330 consecutive patients with nontoxic uninodular goiter underwent thyroidectomy at our institution. In 31 patients, lesions were limited to the thyroid isthmus with evidence of benign or undetermined pathology on ultrasound-guided fine-needle aspiration biopsy.

The effects of successful parathyroidectomy on clinical and biological manifestations of primary hyperparathyroidism.

Purpose: To assess changes of clinical manifestations, laboratory data, and bone mineral density after parathyroidectomy for primary hyperparathyroidism.

Methods: In 39 patients with symptomatic primary hyperparathyroidism undergoing parathyroidectomy, data of preoperative symptoms and bone densitometry were collected from the medical records. A telephone survey was used to collect information on postoperative symptoms and the patient's degree of satisfaction with the operation.

A forgotten method to induce experimental chronic renal failure in the rat by ligation of the renal parenchyma.

Background: Animal models of chronic renal failure have been widely used in the experimental nephrology laboratories. The most common technique used is the 5/6 reduction of renal mass, either by surgical resection or by infarction.

Methods: In the present work, we describe a forgotten technique based in the ligation of the renal parenchyma in both renal poles.

Strangulated small bowel evisceration after intraperitoneal drainage.

We report an exceptional case of strangulated small bowel evisceration through an intraperitoneal drainage after open cholecystectomy. It is a recognized but rare complication of surgical procedures. The drainage must be sited carefully and when necessary.

Subtotal thyroidectomy with transposition of the remnant gland to the subcutaneous space. A new alternative technique in benign thyroid disease.

Background: Thyroidectomy is the preferred surgical option for the treatment of benign disease of the thyroid in a wide rage of indications. Controversy exists concerning the extent of the primary excision for optimal results. A subtotal thyroidectomy with transposition of the thyroid remnant to the subcutaneous space prevents thyroid hormone supplementation for life and laryngeal nerve damage during a re-operation.

[Venous microanastomoses by extraluminal cuff versus standard technique].

Aim: Venous microanastomoses are more difficult to carry out in comparison with the arterial ones, because of the characteristics of the vascular wall. The suture with loose stitches is the usual surgical technique, but it has 2 disadvantages: a long time of execution and the presence of foreign material in the anastomosis. To avoid these complications, we an extraluminal silicone cuff has been used.

[Verneuil's disease or perianal hydradenitis suppurativa].

Verneuil's disease or perianal hidradenitis suppurativa is a chronic suppurative disease with a tendency to fistulization and sclerosis, developing on the subcutaneous tissue, on apocrine glands. The perianal location is the most frequent, and the elective therapy in such case is surgery. A case of perianal Verneuil's disease of great size, invalidating for the patient, in which medical therapy failed, making necessary an aggressive surgical treatment is reported.

[Intraperitoneal hemorrhage caused by cavernous hemangioma of the small intestine].

We report a case of hemorrhage into the abdominal cavity due to the rupture of an intestinal cavernous hemangioma. Out of the 30 published cases from 1976 to 1993 dealing with hemangioma of the small intestine, none presented with intraperitoneal bleeding.

[Perforation of small intestine diverticulum in Ehlers-Danlos syndrome].

We report a case of acute abdomen in a patient previously diagnosed of Ehlers-Danlos syndrome. The pneumoperitoneum on the chest x-ray demanded urgent operative intervention. Laparotomy revealed two diverticula perforations in the small bowel.

[Pelvic fibromatosis, as a cause of abdominal mass].

Pelvic fibromatosis was found in a 26-year-old patient who was operated on for a possible uterine myoma. The histopathological diagnosis revealed an idiopathic retroperitoneal fibrosis. A second operation was performed in order to complete the exercise of the mass.