Concepts in Thyroid, Parathyroid, and Adrenal Surgery

Philip M. Spanheimer; Ronald J. Weigel

doi:10.1007/978-1-4614-1393-6_119

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Book chapter

Concepts in Thyroid, Parathyroid, and Adrenal Surgery

Philip M. Spanheimer and Ronald J. Weigel

Chassin's Operative Strategy in General Surgery, pp.1043-1049

Springer New York

10/22/2013

DOI: 10.1007/978-1-4614-1393-6_119

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Abstract

Surgery of the thyroid, parathyroid, and adrenal glands is an anatomically and physiologically complex field. Operative intervention on the thyroid gland involves either a thyroid lobectomy, total thyroidectomy, or completion thyroidectomy after previous thyroid surgery. The operative extent is dependent on the symptoms and specific pathology being treated, as well as the underlying risk for malignancy. In cases of possible malignancy, patients are treated with thyroid lobectomy with completion thyroidectomy for proven malignancy. The diagnosis and treatment of hyperparathyroidism is an evolving field. Increased biochemical detection has led to an increasing frequency of the diagnosis of hyperparathyroidism. Treatment of primary hyperparathyroidism is achieved by surgical removal of a hyperfunctioning gland in the case of an adenoma or resection of several glands in the case of multiglandular disease. Total parathyroidectomy with or without reimplantation or “3 ½ gland resection” is used in cases of secondary hyperparathyroidism for patients with renal failure. With improvements in imaging modalities, there is now a role for minimally invasive parathyroidectomy without four-gland exploration in select patients. Surgical management of adrenal disorders is typically reserved for medically refractory cases or suspected malignancy. Patients at risk for pheochromocytoma should be screened, and those with pheochromocytoma should undergo alpha blockade and adrenal management prior to other procedures. Laparoscopic adrenalectomy can be safely performed in patients with gland size less than 6 cm and who are not believed to have adrenocortical carcinoma.

Adrenocortical Carcinoma

Central Neck Dissection

Completion Thyroidectomy

Laparoscopic Adrenalectomy

Minimally Invasive Parathyroidectomy

Details

Title: Subtitle: Concepts in Thyroid, Parathyroid, and Adrenal Surgery
Creators: Philip M. Spanheimer - University of Iowa
Ronald J. Weigel - University of Iowa Hospitals and Clinics
Resource Type: Book chapter
Publication Details: Chassin's Operative Strategy in General Surgery, pp.1043-1049
DOI: 10.1007/978-1-4614-1393-6_119
Publisher: Springer New York; New York, NY
Language: English
Date published: 10/22/2013
Academic Unit: Molecular Physiology and Biophysics; Anatomy and Cell Biology; Surgery; Biochemistry and Molecular Biology
Record Identifier: 9984288823102771

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