Surgery
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Multicenter Study
Is DVT prophylaxis necessary for thyroidectomy and parathyroidectomy?
Recent guidelines suggest pharmacologic deep vein thrombosis (DVT) prophylaxis in all patients undergoing major surgical procedures to minimize the risk of postoperative DVT and pulmonary embolism (PE). Pharmacologic DVT prophylaxis perioperatively might increase the risk of bleeding complications. Our goal was to study the risk/benefit ratio of DVT prophylaxis in patients who undergo thyroidectomy and parathyroidectomy. ⋯ Patients who underwent thyroidectomy and parathyroidectomy have a low incidence of developing DVT/PE complications and have a significantly greater risk of developing bleeding complications. Hence, we believe that DVT prophylaxis should be done at the discretion of the surgeon in select high-risk patients only.
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Prophylactic central lymph node dissection with total thyroidectomy (TT) for the treatment of papillary thyroid cancer (PTC) is controversial because of the possibility of increased morbidity with uncertain benefit. The purpose of this study is to determine whether prophylactic central neck dissection provides any advantages over TT alone. ⋯ The addition of routine central lymph node dissection to TT for the treatment of PTC upstages nearly one third of patients over the age of 45 thereby changing the dose of radioactive iodine ablative therapy, but does not change postoperative thyroglobulin levels after completion of radioiodine treatment.