1
|
Del Rio P, Polistena A, Chiofalo MG, De Pasquale L, Dionigi G, Docimo G, Graceffa G, Iacobone M, Medas F, Pezzolla A, Sorrenti S, Spiezia S, Calò PG. Management of surgical diseases of thyroid gland indications of the United Italian Society of Endocrine Surgery (SIUEC). Updates Surg 2023; 75:1393-1417. [PMID: 37198359 PMCID: PMC10435599 DOI: 10.1007/s13304-023-01522-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 04/23/2023] [Indexed: 05/19/2023]
Abstract
A task force of the United Italian society of Endocrine Surgery (SIUEC) was commissioned to review the position statement on diagnostic, therapeutic and health‑care management protocol in thyroid surgery published in 2016, at the light of new technologies, recent oncological concepts, and tailored approaches. The objective of this publication was to support surgeons with modern rational protocols of treatment that can be shared by health-care professionals, taking into account important clinical, healthcare and therapeutic aspects, as well as potential sequelae and complications. The task force consists of 13 members of the SIUEC highly trained and experienced in thyroid surgery. The main topics concern clinical evaluation and preoperative workup, patient preparation for surgery, surgical treatment, non-surgical options, postoperative management, prevention and management of major complications, outpatient care and follow-up.
Collapse
Affiliation(s)
- P Del Rio
- Unit of General Surgery, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - A Polistena
- Department of Surgery Pietro Valdoni, University of Rome Sapienza, Rome, Italy
| | - M G Chiofalo
- Department Head and Neck, Thyroid Surgery Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - L De Pasquale
- Thyroid and Parathyroid Service, Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - G Dionigi
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Division of Surgery, Istituto Auxologico Italiano Instituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - G Docimo
- Division of Thyroid Surgery, University of Campania "L. Vanvitelli", Naples, Italy
| | - G Graceffa
- Department of Surgical Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - M Iacobone
- Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology, Padova University Hospital, Padova, Italy
| | - Fabio Medas
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy.
| | - A Pezzolla
- Division of Videolaparoscopic Surgery, Department of Emergency and Organ Transplanatation, University of Bari "A. Moro", Bari, Italy
| | - S Sorrenti
- Department of Surgery, "Sapienza" University of Rome, Rome, Italy
| | - S Spiezia
- Department of Endocrine and Ultrasound-guided Surgery, Ospedale del Mare, Naples, Italy
| | - P G Calò
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| |
Collapse
|
2
|
Beheshti Firoozabadi J, Mahdavi R, Shamsi K, Ataee H, Shafiee A, Ebrahiminik H, Chegini H, Hoseinpour P, Moradi A, Yousefpour N, Aghaei F, Fardoost A, Ghelichli A, Mokhtari Dowlatabad H, Hajighasemi F, Sami N, Rouhollah Miri S, Akbari ME, Abdolahad M. Intraoperative Assessment of High-Risk Thyroid Nodules Based on Electrical Impedance Measurements: A Feasibility Study. Diagnostics (Basel) 2022; 12:diagnostics12122950. [PMID: 36552958 PMCID: PMC9776834 DOI: 10.3390/diagnostics12122950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/06/2022] [Accepted: 11/18/2022] [Indexed: 11/29/2022] Open
Abstract
Precise diagnosis of thyroid nodules is challenging due to non-diagnostic/inconclusive results and uncertainties about the malignancy of follicular neoplasms (FNs), even in frozen-section pathology. Therefore, surgical management, especially in Bethesda III and IV categories, may be complicated, and sometimes a second surgery may be required. The Thyroid Nodule Impedance Measurement System (TN-IMS) consists of a metallic patch attached to submental skin and a G20 I.V. cannula inserted into the targeted nodules. Two impedance-based parameters named Z1kHz and impedance phase slope (IPS) in 100 kHz to 500 kHz of the thyroid nodules are recorded and compared with their histopathological results as the gold standard. TN-IMS was intra-surgically applied to 103 human thyroid nodules and normal thyroid tissues. A remarkable consistency between defined co-ranges of Z1kHz/IPS and the histopathological status of specimens was achieved (p < 0.001). Based on these measurements, it was concluded that intraoperative bioelectrical impedance scanning of thyroid nodules would be a helpful complementary approach to detecting high-risk excision-required thyroid nodules.
Collapse
Affiliation(s)
- Jalil Beheshti Firoozabadi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran 14166-34793, Iran
- Nano Bioelectronics Devices Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran 14399-57131, Iran
| | - Reihane Mahdavi
- Nano Bioelectronics Devices Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran 14399-57131, Iran
- Cancer Electronics Research Center, University of Tehran and Tehran University of Medical Sciences Imam Khomeini Hospital, Tehran 14197-33141, Iran
| | - Khosro Shamsi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran 14166-34793, Iran
- Nano Bioelectronics Devices Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran 14399-57131, Iran
| | - Hossein Ataee
- Nano Bioelectronics Devices Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran 14399-57131, Iran
- Cancer Electronics Research Center, University of Tehran and Tehran University of Medical Sciences Imam Khomeini Hospital, Tehran 14197-33141, Iran
- Department of Electrical Engineering, Amirkabir University of Technology, Tehran 15916-34311, Iran
| | - Abdollah Shafiee
- Nano Bioelectronics Devices Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran 14399-57131, Iran
- Department of Surgery, Farmanieh Hospital, Tehran 19537-34411, Iran
| | - Hojat Ebrahiminik
- Department of Internentional Radiology and Radiation Sciences Research Center, Aja University of Medical Sciences, Tehran 14117-18541, Iran
- Interventional Radiology Department, Tirad Imaging Institute, Tehran 15867-36513, Iran
| | - Hossein Chegini
- Nano Bioelectronics Devices Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran 14399-57131, Iran
- Interventional Radiology Department, Tirad Imaging Institute, Tehran 15867-36513, Iran
| | - Parisa Hoseinpour
- Nano Bioelectronics Devices Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran 14399-57131, Iran
- Department of Pathology, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran 15179-64311, Iran
| | - Afshin Moradi
- Department of Pathology, Shohada Hospital, Shahid Beheshti University of Medical Sciences, Tehran 14166-34793, Iran
| | - Narges Yousefpour
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran 14166-34793, Iran
- Cancer Electronics Research Center, University of Tehran and Tehran University of Medical Sciences Imam Khomeini Hospital, Tehran 14197-33141, Iran
| | - Faeze Aghaei
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran 14166-34793, Iran
- Cancer Electronics Research Center, University of Tehran and Tehran University of Medical Sciences Imam Khomeini Hospital, Tehran 14197-33141, Iran
| | - Ali Fardoost
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran 14166-34793, Iran
| | - Alireza Ghelichli
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran 14166-34793, Iran
- Cancer Electronics Research Center, University of Tehran and Tehran University of Medical Sciences Imam Khomeini Hospital, Tehran 14197-33141, Iran
| | - Hadi Mokhtari Dowlatabad
- Nano Bioelectronics Devices Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran 14399-57131, Iran
- Cancer Electronics Research Center, University of Tehran and Tehran University of Medical Sciences Imam Khomeini Hospital, Tehran 14197-33141, Iran
| | - Farzane Hajighasemi
- Nano Bioelectronics Devices Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran 14399-57131, Iran
- Cancer Electronics Research Center, University of Tehran and Tehran University of Medical Sciences Imam Khomeini Hospital, Tehran 14197-33141, Iran
| | - Nafiseh Sami
- Department of Medicine, Islamic Azad University of Medical Sciences, Tehran 19395-1495, Iran
| | - Seyed Rouhollah Miri
- Cancer Electronics Research Center, University of Tehran and Tehran University of Medical Sciences Imam Khomeini Hospital, Tehran 14197-33141, Iran
- Department of Surgical Oncology, Tehran University of Medical Science, Tehran 14176-14411, Iran
- Cancer Institute, Imam-Khomeini Hospital, Tehran University of Medical Sciences, Tehran 14166-34793, Iran
| | - Mohammad Esmaeil Akbari
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran 14166-34793, Iran
- Correspondence: (M.E.A.); (M.A.)
| | - Mohammad Abdolahad
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran 14166-34793, Iran
- Nano Bioelectronics Devices Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran 14399-57131, Iran
- Cancer Electronics Research Center, University of Tehran and Tehran University of Medical Sciences Imam Khomeini Hospital, Tehran 14197-33141, Iran
- Cancer Institute, Imam-Khomeini Hospital, Tehran University of Medical Sciences, Tehran 14166-34793, Iran
- Correspondence: (M.E.A.); (M.A.)
| |
Collapse
|
3
|
Albano D, Treglia G, Dondi F, Giubbini R, Galani A, Cappelli C, Bertagna F, Casella C. Comparison between total thyroidectomy and hemithyroidectomy in TIR3B thyroid nodules management. Endocrine 2022; 78:315-320. [PMID: 35986138 PMCID: PMC9584867 DOI: 10.1007/s12020-022-03162-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/31/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE Thyroid nodules classified as TIR3B according to SIAPEC 2014 are considered a clinical challenge due to the risk to be malignant. This retrospective study aimed to compare the performances of total thyroidectomy (TT) and hemithyroidectomy (HT) in the surgical management of a consecutive cohort of patients affected by TIR3B thyroid nodule in terms of side effects and the rate of malignancy detected. METHODS From 2011 to 2019, 136 (111 women, 25 men; average age of 53.5 years) patients having a thyroid nodule with a cytological diagnosis of TIR3B who underwent TT or HT were retrospectively included. RESULTS Out of 136 patients, 106 (78%) received TT, while the remaining 30 (22%) HT. The final diagnosis was malignant in 65 patients (48%), with follicular variant of papillary carcinoma as the most frequent. The diagnosis of malignancy was significantly more common in the TT group with 56 patients (53%) compared to the HT group with 9 cases (30%) (p = 0.001). Patients who underwent TT were significantly older, had larger nodules and the time between diagnosis and surgery was significantly longer compared to HT (p = 0.001; p0.003; p = 0.002). No main post-surgical complications were registered, except for one case of transient hypocalcemia in a patient who underwent TT. CONCLUSIONS Our data showed a malignancy rate of TIR3B lesions higher than expected (48%). Both TT and HT seem to be effective approaches for the treatment of TIR3B nodules with a very low rate of post-surgical comorbidities. In the choice of surgical approach, it is crucial to consider the presence of risk factors (clinical and ultrasound characteristics), nodule size, patients' opinion, and surgeon's skills and experience.
Collapse
Affiliation(s)
- Domenico Albano
- Nuclear Medicine, ASST Spedali Civili Brescia, Brescia, Italy.
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health; Nuclear Medicine, University of Brescia, Brescia, Italy.
| | - Giorgio Treglia
- Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Francesco Dondi
- Nuclear Medicine, ASST Spedali Civili Brescia, Brescia, Italy
| | - Raffaele Giubbini
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health; Nuclear Medicine, University of Brescia, Brescia, Italy
| | - Alessandro Galani
- Department of Clinical and Experimental Sciences, Surgical Clinic, University of Brescia, Brescia, Italy
| | - Carlo Cappelli
- Department of Clinical and Experimental Sciences, SSd Medicina ad Indirizzo Endocrino-Metabolico, University of Brescia, Brescia, Italy
| | - Francesco Bertagna
- Nuclear Medicine, ASST Spedali Civili Brescia, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health; Nuclear Medicine, University of Brescia, Brescia, Italy
| | - Claudio Casella
- Department of Molecular and Translation Medicine, Surgical Clinic, University of Brescia, Brescia, Italy
| |
Collapse
|