World journal of surgery
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World journal of surgery · Jun 2012
Randomized Controlled TrialCombination of dexamethasone and tropisetron before thyroidectomy to alleviate postoperative nausea, vomiting, and pain: randomized controlled trial.
Nausea, vomiting, and pain frequently occur after thyoidectomy. Little evidence exists regarding the effects of administrating a combination of dexamethasone and tropisetron to patients undergoing thyroidectomy. We aimed to evaluate the effects of dexamethasone and tropisetron on thyroidectomy outcomes. ⋯ The combination of dexamethasone and tropisetron offers better prophylaxis for nausea, vomiting, and pain than either drug alone in patients undergoing thyroidectomy, especially during the late period (6-48 h).
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World journal of surgery · Jun 2012
Clinical TrialCombining early postoperative parathyroid hormone and serum calcium levels allows for an efficacious selective post-thyroidectomy supplementation treatment.
Optimal treatment protocol to prevent symptomatic hypocalcemia following total thyroidectomy is still matter of debate. We prospectively evaluated the efficacy of a selective supplementation protocol based on both early postoperative intact parathyroid hormone (iPTH) and serum calcium levels. ⋯ The proposed supplementation protocol seems efficacious in preventing symptomatic hypocalcemia. It could allow a safe and early discharge of most patients, thus avoiding the constraints and the costs of routine supplementation.
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World journal of surgery · Jun 2012
Evaluation of postoperative radioactive iodine scans in patients who underwent prophylactic central lymph node dissection.
Prophylactic central lymph node dissection (CLND) accompanying total thyroidectomy for papillary thyroid cancer (PTC) remains controversial. Our hypothesis is that CLND may help select patients who benefit from postoperative radioactive iodine (RAI). ⋯ Few node-negative patients have abnormal RAI scans outside of the thyroid bed. Node-positive patients had greater variability in stimulated 1-year Tg levels after higher doses of RAI. CLND may identify the patients most likely to have persistently elevated stimulated Tg after initial therapy for PTC.
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World journal of surgery · Jun 2012
Level VI lymph node dissection does not decrease radioiodine uptake in patients undergoing radioiodine ablation for differentiated thyroid cancer.
In patients with well-differentiated thyroid cancer, the incidence of pathologic central compartment lymph node metastases is reported to be approximately 50%. Recently level VI lymph node dissection has been advocated as a means of reducing recurrence rates in these patients, even if there are no clinically apparent nodal metastases. This study investigates whether level VI lymph node dissection decreases the percent radioiodine uptake when patients undergo radioiodine ablation. ⋯ There is no evidence that uptake of (131)I is reduced by performance of a central neck dissection in patients with well-differentiated thyroid cancer. Preablation thyroglobulin levels were not altered by level VI lymph node dissection.
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World journal of surgery · May 2012
Review Meta AnalysisSomatostatin analogues for the treatment of enterocutaneous fistulas: a systematic review and meta-analysis.
Enterocutaneous fistulas are abnormal connections between the skin and gastrointestinal tract that most commonly occur after surgery. Somatostatin analogues have been used in their treatment. The objective of the present study was to determine if somatostatin analogues shorten the time to closure of postoperative enterocutaneous fistulas compared to placebo. ⋯ Somatostatin analogues appear to decrease the duration of enterocutaneous fistulas and duration of hospital stay, but no mortality benefit was identified. The quality of evidence for outcomes in this review ranged from low to moderate. Future large, blinded, RCT would be useful in improving the confidence in the treatment effects identified in this systematic review and meta-analysis.