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JAYPEE JOURNALS
International Scientific Journals from Jaypee
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List of All Articles
1.  How I Do It
Transoral Endoscopic Thyroid Surgery through Vestibular Approach
Gyan Chand, SK Mishra
[Year:2016] [Month:May-August] [Volume:8 ] [Number:2] [Pages:52] [Pages No:179-182] [No of Hits : 869]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10002-1187 | FREE

ABSTRACT

Scarless neck surgery for thyroid became popular after the advancement of endoscopic and robotic thyroid surgery. Different approaches have been practiced for endoscopic thyroid surgery in different parts of the world.

Keywords: Endoscopic thyroid surgery, Endoscopic thyroid surgical techniques, Transoral thyroid surgery.

How to cite this article: Chand G, Mishra SK. Transoral Endoscopic Thyroid Surgery through Vestibular Approach. World J Endoc Surg 2016;8(2):179-182.

Source of support: Nil

Conflict of interest: None

 
2.  Review Article
Management of Chyle Leak in the Neck Following Thyroid Cancer Surgery: A Single Center Experience
Anish Cherian, Pooja Ramakant, Mazhuvanchary Jacob Paul, Deepak Thomas Abraham
[Year:2015] [Month:January-April] [Volume:7 ] [Number:1] [Pages:27] [Pages No:6-9] [No of Hits : 1470]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10002-1156 | FREE

ABSTRACT

Introduction: Surgery for thyroid cancers often necessitates a neck dissection. This is usually a safe procedure, but can be associated with complications. Chyle leak is one such complication, fortunately rare. There is a dearth of literature with regard to the management of chyle leak in the neck. We present a single center experience in the management of chyle leak in the neck, to improve the understanding of its management.

Materials and methods: A retrospective analysis of patients with thyroid cancer, managed between January 1st 2005 and December 31st 2011, in a single institution was performed. Among these, patients with chyle leak were identified. All pertinent data collected and results analyzed using STATA (v10).

Results: Three hundred and seventy-three/eight hundred and twenty-one (45.4%) patients surgically managed for thyroid cancer underwent a neck dissection. Thoracic duct injury was recog- nized and managed intraoperatively in 20/373 (5.4%) patients. The leak was prevented in the majority (66.6%) of patients in whom a combination of methods were employed. 25/373 (6.7%) patients were diagnosed and managed for chyle leak postoperatively. Seven patients required re-exploration. This included patients with low output chyle leaks who may have settled in a week to 10 days with conservative management. A combination of techniques was successful in the majority (71.4%). The remaining patients were successfully managed conservatively.

Conclusion: We conclude that using a combination of methods to manage thoracic duct injury may be better than using a single modality alone. Early re-exploration was more economical and acceptable for a subset of our patients, as they come from long distances at personal cost.

Keywords: Thyroidectomy, Chyle leak, Thyroid cancer, Modified radical neck dissection.

How to cite this article: cherian a, Ramakant P, Paul MJ, Abraham DT. Management of Chyle Leak in the Neck Following Thyroid Cancer Surgery: A Single Center Experience. World J Endoc Surg 2015;7(1):6-9.

Source of support: Nil

Conflict of interest: None

 
3.  Original Article
Location of Parathyroid Adenomas in Primary Hyperparathyroidism: Where to look?
Pinar Yazici, Mehmet Mihmanli, Emre Bozdag, Nurcihan Aygun, Mehmet Uludag
[Year:2015] [Month:January-April] [Volume:7 ] [Number:1] [Pages:27] [Pages No:1-5] [No of Hits : 1005]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10002-1155 | FREE

ABSTRACT

Purpose: Preoperative localization studies for parathyroid adenomas are very essential to perform minimal invasive parathyroidectomy (MIP) with decreased operative time and potential complications. Although most of these studies based on radiological imaging, intraoperative assessment provides the most accurate anatomical description of the location of parathyroid adenomas. In this study, we aim to evaluate the surgical variations of locations of parathyroid adenomas in patients performed parathyroid surgery for primary hyperparathyroidism (PHPT).

Materials and methods: Between January 2010 and December 2013, 243 patients (201 women/42 men) who underwent parathyroid surgery due to phPT were included. A total of 254 parathyroid adenomas were detected. Demographic features, preoperative work-up, surgical approach, types of procedures and postoperative complications were noted. Locations of parathyroid adenomas were recorded from operative notes. Statistical analysis was performed using t-test and chi-square. continuous data are expressed as mean ± standard deviation.

Results: With regard to the most frequently observed, location of adenomas were as follows; right inferior (n = 89, 37.7%), left inferior (n = 78, 33%), right superior (n = 44, 18.6%), left superior (n = 25, 10.5%) and ectopic locations (n = 18). Ectopic adenomas were mostly located in the thymus (n = 9) and intrathyroidal tissue (n = 6) at a rate of 83%. Postoperative hypocalcemia (11%) was mostly seen in those with parathyroid adenoma located around the inferior lobes of the thyroid (86%) and undergoing bilateral neck exploration (75%).

Conclusion: The most of the parathyroid adenomas were found in orthotopic position and located around the lower pole of the thyroid gland. Ectopic adenomas were mostly located in thymus or intrathyroidal. Postoperative hypocalcemia was also higher in those with parathyroid adenoma located around the inferior lobe of the thyroid.

Keywords: Parathyroid anatomy, Primary hyperparathyroidism, Parathyroid adenoma, Surgical Approach.

How to cite this article: Yazici P, Mihmanli M, Bozdag E, Aygun N, Uludag M. Location of Parathyroid Adenomas in Primary Hyperparathyroidism: Where to look? World J Endoc Surg 2015;7(1):1-5.

Source of support: Nil

Conflict of interest: None

 
4.  Case Report
A Unique Case of O steitis Fibrosa Cystica with Postoperative Hungry Bone Syndrome and Hypocalcemic Cardiac Failure
Ramesh Maturi, Hemanth Makineni, Sri Santhosh Keerthi Marri
[Year:2015] [Month:January-April] [Volume:7 ] [Number:1] [Pages:27] [Pages No:10-13] [No of Hits : 987]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10002-1157 | FREE

ABSTRACT

Osteitis fibrosa cystica, a manifestation of severe hyperparathyroidism presenting with crippling bone deformities is a rare presentation these days. We report a case of 40-year-old male patient who presented with generalized aches and pains and bony deformities. Radiographs showed diffuse osteopenia, brown tumors and pathological fractures of phalanges but common manifestations associated with hyperparathyroidism like pancreatic calcifications and nephrolithiasis were absent. Serum calcium and parathyroid hormone levels were elevated while ultrasound imaging of neck showed the presence of a left lower parathyroid adenoma and was confirmed by Tc99- sestamibi scan. Large parathyroid lesion along with high calcium levels and severely elevated PTH puts this patient in high-risk category for postoperative hungry bone syndrome leading to severe hypocalcemia postoperatively. Hypocalcemia usually results in neuromuscular irritability manifesting as paresthesia, Chvostek and Trousseau sign, carpopedal spasm and even convulsions in severe cases. However, our patient had none of the common manifestations, but developed hypocalcemic cardiac failure postoperatively. Case history and management of case is presented.

Keywords: Hyperparathyroidism, Parathyroid adenoma, Hypocalcemia, Hypocalcemic cardiac failure, Hungry bone syndrome.

How to cite this article: Maturi R, Makineni H, Marri SSK. A Unique Case of Osteitis Fibrosa Cystica with Postoperative Hungry Bone Syndrome and Hypocalcemic Cardiac Failure. World J Endoc Surg 2015;7(1):10-13.

Source of support: Nil

Conflict of interest: None

 
5.  Case Report
A Cautionary Case: Adrenal Insufficiency after Unilateral Adrenalectomy for Adrenocortical Carcinoma
Heather Player, Robert Babkowski, Xiang Dong
[Year:2015] [Month:January-April] [Volume:7 ] [Number:1] [Pages:27] [Pages No:17-20] [No of Hits : 911]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10002-1159 | FREE

ABSTRACT

Subclinical Cushing’s syndrome among patients with incidentally discovered adrenal masses has been well documented in the literature. This population does not exhibit the classic signs of Cushing’s syndrome, but nonetheless present with postoperative adrenal insufficiency after unilateral adrenalectomy of nonfunctioning incidentalomas. Further, the results of extensive preoperative testing do not correlate with postoperative hypoadrenalism with adequate sensitivity. The patient is an 84-year-old male, who presented with vague complaints of abdominal pain and fatigue, with computed tomography (CT) scan demonstrating an enlarging left adrenal gland up to 5.5 cm. The patient had no evidence of hypothalamic-pituitary-adrenal axis dysfunction based on history, physical examination and preoperative testing. Thus, the lesion was presumed nonfunctional and was excised laparoscopically. Pathology demonstrated an unfortunate diagnosis of adrenocortical carcinoma (ACC). On postoperative day 1, the patient exhibited hypotension and hypoglycemia, with a cortisol level of 0.3 mg/dl. The patient responded to hydrocortisone, supporting the presumed diagnosis of hypoadrenalism. ACC is a rare and aggressive tumor, with only 300 documented cases per year in the United States. Thus, there is a paucity of data related to pre- and postoperative management. Since a third of the patients present with nonfunctioning tumors, postsurgical care are based on literature from nonfunctional incidentalomas until further research establishes guidelines. Our experience with acute hypoadrenalism after unilateral adrenalectomy in the setting of ACC suggests the need for routine postoperative testing of cortisol levels.

Keywords: Adrenocortical carcinoma, adrenal insufficiency, Adrenalectomy, Steroid replacement, Hypoadrenalism.

How to cite this article: Player H, Babkowski R, Dong X. A Cautionary Case: Adrenal Insufficiency after Unilateral Adrenalectomy for Adrenocortical Carcinoma. World J Endoc Surg 2015;7(1):17-20.

Source of support: Nil

Conflict of interest: None

 
6.  MINI REVIEW
Tubercle of Zuckerkandl
Sabaretnam Mayilvaganan, Naval Bansal, Navneet Tripathi, Ashwini Reddy, Amit Agarwal
[Year:2015] [Month:May-August] [Volume:7 ] [Number:2] [Pages:25] [Pages No:33-35] [No of Hits : 855]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10002-1163 | FREE

ABSTRACT

Endocrine Surgeon must have intimate knowledge about all anatomic variations of thyroid gland for performing safe thyroid surgery. Tubercle of Zuckerkandl is a posterior extrusion of the lateral thyroid lobes and it is a pointer to the recurrent laryngeal nerve and inferior parathyroid glands. We have discussed pertinent issues regarding tubercle of Zuckerkandl in this mini review.

Keywords: Pointer, Recurrent laryngeal nerve, Tubercle of Zuckerkandl.

How to cite this article: Mayilvaganan S, bansal N, Tripathi N, Reddy A, Agarwal A. Tubercle of Zuckerkandl. World J Endoc Surg 2015;7(2):33-35.

Source of support: Nil

Conflict of interest: None

 
7.  How We Do It
Statistical Methods in Endocrine Surgery Journal Club
Prabhaker Mishra, Sabaretnam Mayilvaganan, Amit Agarwal
[Year:2015] [Month:January-April] [Volume:7 ] [Number:1] [Pages:27] [Pages No:21-23] [No of Hits : 825]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10002-1160 | FREE

ABSTRACT

Endocrine surgery is a relatively newer surgical subspecialty with few dedicated endocrine surgery departments and journals. To understand the published literature, knowledge of some common statistical methods are not only useful but also significant to publish own research successfully. This paper present a brief review of common statistical methods, used for data analysis in conducting medical research.

Keywords: endocrine surgery, statistical methods, journal club, normal data, parametric test, survival analysis, regression analysis, roc curve.

How to cite this article: Mishra P, Mayilvaganan S, Agarwal A. Statistical Methods in Endocrine Surgery Journal Club. World J Endoc Surg 2015;7(1):21-23.

Source of support: Nil

Conflict of interest: None

 
8.  Letter-To-Editor
Safety and Cost Efficiency in Thyroid Surgery
Sabaretnam Mayilvaganan, Amit Agarwal
[Year:2015] [Month:January-April] [Volume:7 ] [Number:1] [Pages:27] [Pages No:26-27] [No of Hits : 698]
Full Text PDF | Abstract | FREE

ABSTRACT

Dear editor,
We read with interest the article ‘safety and cost efficiency in thyroid surgery’ by Young-Chul OT and Gough I.1 We congratulate the authors on their work which is aimed toward reducing the cost and also providing a safe approach with acceptable clinical indicators for the outcome of thyroid surgery. This is more so relevant in the developing world, where the endocrine surgeon has to balance between the usage of newer technology as well as curtailing the cost of the procedure. Sutureless thyroidectomy using vessel sealing devices which have become a routine in most centers.2

 
9.  Endocrine Image
Primary Pigmented Nodular Adrenocortical Disease: A Rare Cause of Cushing’s Syndrome
Dhalapathy Sadacharan, Shriraam Mahadevan, Krishnan Ravikumar, Sankaran Muthukumar
[Year:2015] [Month:January-April] [Volume:7 ] [Number:1] [Pages:27] [Pages No:24-25] [No of Hits : 662]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10002-1161 | FREE

ABSTRACT

Primary pigmented nodular adrenocortical disease (PPNAD) is one of the rare cause of adrenocorticotropic hormone (ACTH) independent Cushing’s syndrome. More than 90% of the reported PPNAD have been associated with Carney’s complex. Primary pigmented nodular adrenocortical disease is one of the major criteria for the diagnosis of Carney’s complex (CNC). We report a case of PPNAD which is not associated with CNC.

Keywords: Cushing’s syndrome, Primary pigmented nodular adrenocortical disease, Bilateral adrenalectomy.

How to cite this article: Sadacharan D, Mahadevan S, Ravikumar K, Muthukumar S. Primary Pigmented Nodular Adrenocortical Disease: A Rare Cause of Cushing’s Syndrome. World J Endoc Surg 2015;7(1):24-25.

Source of support: Nil

Conflict of interest: None

 
10.  Case Report
Surgical Delight: Nonrecurrent Laryngeal Nerve
Krishnan Ravikumar, Dhalapathy Sadacharan, RV Suresh
[Year:2015] [Month:January-April] [Volume:7 ] [Number:1] [Pages:27] [Pages No:14-16] [No of Hits : 642]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10002-1158 | FREE

ABSTRACT

Introduction: A nonrecurrent course is an unusual anatomic variation of the recurrent laryngeal nerve. It is seen usually on the right side, and it is very rare on the left side. Nonrecurrent laryngeal nerve if present is mostly associated with vascular anomalies.

Case report: A 55-year-old female was referred to us with thyrotoxic symptoms for a period of 6 months. She was rendered euthyroid with antithyroid medications. After complete evaluation, she was posted for total thyroidectomy. Intraoperatively, right recurrent nerve could not be identified in usual position. On careful dissection, a nonrecurrent laryngeal nerve was identified. The recurrent laryngeal nerve on the left side showed normal course. The intraoperative and postoperative period were uneventful. Postoperative vocal cord status was normal.

Conclusion: This case was presented for its rarity and to stress the need for orderly meticulous surgical dissection.

Keywords: Nonrecurrent laryngeal nerve, Recurrent laryngeal nerve, Inferior laryngeal nerve.

How to cite this article: Ravikumar K, Sadacharan D, Suresh Rv. Surgical Delight: Nonrecurrent Laryngeal Nerve. World J Endoc Surg 2015;7(1):14-16.

Source of support: Nil

Conflict of interest: None

 
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