8/25/2023 0 Comments Because i love her chapter 21We now know that cachexia strumipriva was surgical hypothyroidism. As a result, he stopped performing total resection of the thyroid. Kocher recognized that this dreaded syndrome developed only in patients who had total thyroidectomy. He described “cachexia strumipriva” in patients years after thyroidectomy (Fig. Kocher, a master thyroid surgeon who operated in the late nineteenth and early twentieth centuries in Bern, practiced meticulous surgical technique and greatly reduced the mortality and operative morbidity of thyroidectomy for goiter (3). The mortality associated with thyroidectomy was high, recurrent laryngeal nerve injuries were common, and tetany was thought to be caused by “hysteria.” The parathyroid glands in humans were not discovered until 1880 by Sandstrom (2), and the fact that hypocalcemia was the definitive cause of tetany was not wholly accepted until several decades into the twentieth century. Modern thyroid surgery, as we know it today, began in the 1860s in Vienna with the school of Billroth (1). But is there any operative problem propounded so long ago and attacked by so many…which has yielded results as bountiful and so adequate? Dr. There are operations today more delicate and perhaps more difficult…. A feat which today can be accomplished by any competent operator without danger of mishap and which was conceived more than one thousand years ago…. The extirpation of the thyroid gland…typifies, perhaps better than any operation, the supreme triumph of the surgeon’s art…. For complete coverage of this and related areas in Endocrinology, visit our FREE web-book, www, This chapter offers information for physicians and endocrinologists, as well as for surgeons. Sections within this chapter include 1) normal and abnormal anatomy and embryology of the thyroid and surrounding neck structures 2) indications for operation of benign lesions of this gland 3) diagnosis of thyroid nodules, stressing the use of fine needle aspiration with cytologic analysis 4) preparation for operation and care of patients with Graves’ disease 5) surgical approaches for treatment of the different types of thyroid cancer 6) operative techniques for thyroidectomy including descriptions of standard open, minimally invasive, endoscopic, robotic and transoral approaches 7) complications of thyroidectomy and their treatment and 8) developmental abnormalities of the thyroid and their treatment. This chapter presents a clear and concise description of current thought and practice concerning the surgical treatment of thyroid diseases. Thus, diseases of the thyroid gland and their treatment remain one of the most interesting and dynamic areas of study in medicine. Incidence rates of thyroid cancer have increased substantially worldwide in the past several decades.
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