Controversies In Thyroid Surgery

This book encompasses many different diagnoses as well as several specialties of practicing surgeons in the United States. Over the last ten years many advances have been made in preoperative assessment including imaging and diagnostic techniques, operative approaches including “minimally invasive” and robotic surgery, and post operative care. Controversies in Thyroid Surgery explores some of the controversies that arise as the result of these new findings and applications. The book is divided into the two categories of benign diagnosis and cancer topics. Both of these areas lend themselves to separate analysis of specific problems in the areas mentioned above. The text reviews recent data about advances in diagnostic techniques as well as outcomes with specific regards to the newer operative techniques. The textbook will serve as a resource for medical and surgical colleagues involved in the treatment of a wide variety of thyroid diseases. Authors that are experts in their field and have published extensively provide balanced and non-biased views of topics that are admittedly controversial. Controversies in Thyroid Surgery will be of great value and utility to practicing endocrinologists, general surgeons and otolaryngologists.

This book provides a practical, evidence-based approach to controversies in the management of thyroid nodules and differentiated thyroid cancer (DTC). Thyroid nodules are a commonly encountered clinical entity, identified in 2-6% of the population by palpation, and 20-35% by ultrasound. DTC is the solid organ cancer with the most rapidly increasing incidence (>50,000 new cases in the U.S. annually). Despite extensive research and multiple published comprehensive practice guidelines, numerous controversies remain within this field covering a wide range of issues, including incidence and epidemiology, radiographic evaluation, criteria for needle biopsy, cytopathologic and molecular diagnostics, active surveillance vs. operation for low-risk tumors, extent of surgery, indications for radioactive iodine treatment and external beam radiation, and optimal protocols for follow-up. The book takes a case-based approach: each chapter will begin with a patient presentation highlighting a particular controversial subject in thyroid nodules and DTC. The remainder of the chapter discusses the controversy within the context of current scientific understanding and clinical practice, using the latest evidence-based practice guidelines. Chapters conclude with a final review and discussion of the opening case, with options and recommendations for next steps provided. The recommendations are evidence-based and practical, intended to help guide practitioners in their ongoing care of patients with thyroid nodules and DTC. Each chapter was written by a recognized expert in the area of controversy, including endocrine surgeons, endocrinologists, radiologists, medical oncologists, and nuclear medicine specialists. Controversies in Thyroid Nodules and Differentiated Thyroid Cancer: A Case-Based Approach is an excellent guide for oncologists, endocrinologists, otorhinolaryngologists, surgeons, and practitioners of all types that care for patients with thyroid nodules and DTC.

This text encompasses many different thyroid diagnoses as well as several specialties of practicing surgeons in the United States. Over the last ten years many advances have been made in preoperative assessment including imaging and diagnostic techniques, operative approaches including ĺlminimally invasiveĺl and robotic surgery, and post-operative care. This volume also explores some of the controversies that arise as the result of these new findings and applications. The book℗lis divided into two categories of℗lbenign diagnosis and cancer topics. Both of these areas lend themselves to separate analysis of specific problems in the areas mentioned above. The℗ltext reviews recent data about advances in diagnostic techniques as well as outcomes with specific regards to the newer operative techniques in thyroid surgery. Controversies in Thyroid Surgery will serve as a resource for medical and surgical colleagues involved in the treatment of a wide variety of thyroid diseases.>.

An outstanding reference for performing successful thyroid operations Atlas of Thyroid Surgery: Principles, Practice, and Clinical Cases is a concise guide for the surgical management of thyroid disease. Divided in three main parts, the book opens with an overview of surgical anatomy and surgical techniques. The author provides a detailed description of the technique of capsular dissection as well as surgical cases that aid in the comprehension of important concepts. The book then features an in-depth discussion of thyroid nodules, including follicular neoplasms and nodules in Graves and Hashimoto disease, covering basic science, genetics, clinical aspects, imaging, diagnosis, and surgical strategies. In the final part, the atlas addresses the management of malignant tumors, including papillary, anaplastic, and medullary carcinoma, and describes the principles of classification, treatment strategies along with current therapeutic controversies, and results. For differentiated thyroid carcinoma, contemporary strategies focus on selective risk-dependent treatment that allows for the protection of patients from overtreatment.Highlights: Descriptions of endocrine pathophysiology and the pathogenesis of nodular goiter and thyroid neoplasms Thorough discussion of the capsular dissection technique and its essential advantages as a minimally invasive approach with low morbidity Numerous clinical cases with step-by-step demonstrations of surgical procedures and concise comments on management, helping clinicians prepare for range of scenarios encountered in everyday practice 120 clear line drawings and full-color photographs that illustrate key concepts Surgical videos on accompanying Thieme MediaCenter web page present detailed surgical technique in five clinical cases with cross references to the text Atlas of Thyroid Surgery: Principles, Practice, and Clinical Cases is a superb guide for general surgeons and endocrine and ENT surgeons operating on the thyroid. Endocrinologists, oncologists, pathologists, and residents in these specialties will also greatly benefit from the wealth of information provided in the text.

This open access book on thyroid surgery has been authored by an international team of contributors who present a comprehensive understanding of both benign and malignant thyroid disorders. It also outlines an interdisciplinary approach to their surgical management that reflects the latest changes in surgical techniques. The book reviews the most up-to-date literature available on thyroid surgery and presents it in a concise manner for use in clinical practice. For each thyroid disorder, the book covers etiology, clinical manifestations, diagnostic and localization procedures, as well as surgical and non-surgical treatment options. The operating techniques and postoperative management are explained in detail, while the benefits, risks, controversial issues, and cost-effectiveness of each approach are reviewed. To aid in the understanding of complex information, the book features drawings and photographs. Written in an easy-to-understand style, the book includes tables and diagrams that highlight best practices and current guidelines, as well as self-assessment material at the end of each section. It serves as an ideal resource for all levels of surgical experience, from a practical reference for endocrine surgeons to a perfect companion for students and residents.

"Man's natural instinct, in fact, is never toward what is sound and true. It is toward what is specious and false . . . The ideas that conquer the race most rapidly and arouse the wildest enthusiasm and are held most tenaciously are precisely the ideas that are most insane. This has been true since the first 'advanced' gorilla put on underwear, cultivated a frown and began his first lecture tour, . . . " H. L. Mencken, from Meditation On Meditation in the Smart Set, June, 1920 pp 45-46 In our opinion there is no field of clinical medicine in such a state of dynamic disequilibrium as clin ical thyroidology. Thyroid diseases are very common. The moderately complex but easily understandable physiological interrelationships between the thyroid, pituitary and hypothalamus have provided stimuli for the application of mod ern technology in the development of an array of diagnostic procedures. Although therapeutic methods have been more stable, and recent advances more limited, their application by phy- Joel I. Hambufl~er. M. D. sicians representing different disciplines has pro vided an ample basis for the expression of differ ing viewpoints. Unfortunately there are few opportunities for in-depth exploration of different attitudes and experience relevant to issues of current interest. The review process employed by medical journals often seems to stifle the expression of controver sial viewpoints.

This book provides a comprehensive, state-of-the art review of this field, and will serve as a valuable resource for clinicians and researchers with an interest in the management of thyroid nodules and cancer, including both surgeons and endocrinologists. The book reviews new data about risk factors for nodular disease and cancer, details the management of toxic and non-toxic benign thyroid nodular disease, discusses controversies in the management of indeterminate thyroid nodules and cancer, and reviews the latest data on use of molecular testing for diagnosis and prognosis. Lastly, the book reviews the management of difficult-to-treat thyroid cancers. Management of Thyroid Nodules and Differentiated Thyroid Cancer: A Practical Guide will serve as a useful resource for physicians and researchers dealing with, and interested in thyroid nodular disease and cancer. It will provide a concise yet comprehensive summary of the current status of the field that will help guide patient management and stimulate investigative efforts. All chapters are written by experts in their fields and include the most up to date scientific and clinical information.

Drs. Groopman and Hartzband reveal a clear path for making the right medical choices. Such factors as authority figures, statistics, other patients' stories, technology, and natural healing are key factors that shape choices.