Thyroid Surgery Thyroid Surgery Principles and Practice Edited by Madan Laxman Kapre First edition published 2020 by CRC Press 6000 Broken Sound Parkway NW, Suite 300, Boca Raton, FL 33487-2742 and by CRC Press 2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN © 2020 Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, LLC This book contains information obtained from authentic and highly regarded sources. While all reasonable efforts have been made to publish reliable data and information, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. The publishers wish to make clear that any views or opinions expressed in this book by individual editors, authors or contributors are personal to them and do not necessarily reflect the views/opinions of the publishers. The information or guidance contained in this book is intended for use by medical, scientific or health-care professionals and is provided strictly as a supplement to the medical or other professional’s own judgement, their knowledge of the patient’s medical history, relevant manufacturer’s instructions and the appropriate best practice guidelines. Because of the rapid advances in medical science, any information or advice on dosages, procedures or diagnoses should be independently verified. The reader is strongly urged to consult the relevant national drug formulary and the drug companies’ and device or material manufacturers’ printed instructions, and their websites, before administering or utilizing any of the drugs, devices or materials mentioned in this book. This book does not indicate whether a particular treatment is appropriate or suitable for a particular individual. Ultimately it is the sole responsibility of the medical professional to make his or her own professional judgements, so as to advise and treat patients appropriately. The authors and publishers have also attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any elec- tronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers. For permission to photocopy or use material electronically from this work, access www.copyright.com or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. For works that are not available on CCC please contact mpkbookspermissions@ tandf.co.uk Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging-in-Publication Data Names: Kapre, Madan, editor. Title: Thyroid surgery : principles and practice / edited by Madan Kapre. Other titles: Thyroid surgery (Kapre) Description: First edition. | Boca Raton : CRC Press, 2020. | Includes bibliographical references and index. | Summary: “This book will bridge a gap between the huge platform of literature available on the subject of thyroid surgery and the pratical working reality. The pearls in techniques and surgical procedures will be exhaustively detailed with authors’ individual experience enriched with quality photographs”-- Provided by publisher. Identifiers: LCCN 2020006268 (print) | LCCN 2020006269 (ebook) | ISBN 9781138483781 (hbk) | ISBN 9780429086076 (ebk) Subjects: MESH: Thyroid Diseases--surgery | Thyroid Gland--surgery | Thyroid Neoplasms--surgery | Thyroidectomy Classification: LCC RD599.5.T46 (print) | LCC RD599.5.T46 (ebook) | NLM WK 280 | DDC 617.5/39--dc23 LC record available at https://lccn.loc.gov/2020006268 LC ebook record available at https://lccn.loc.gov/2020006269 ISBN: 9781138483781 (hbk) ISBN: 9780429086076 (ebk) Typeset in Minion by Nova Techset Private Limited, Bengaluru & Chennai, India CONTENTS Preface vii Acknowledgments ix Editor xi Contributors xiii Introduction xvii CHAPTER 1 HISTORY AND EVOLUTION OF THYROID SURGERY 1 Cheerag Patel and Subhaschandra Shetty CHAPTER 2 SURGICAL ANATOMY OF THE THYROID 7 Ashutosh Mangalgiri and Deven Mahore CHAPTER 3 CLINICAL ASSESSMENT OF THE THYROID NODULE 15 Madan Laxman Kapre, Shripal Jani, and Priya Dubey CHAPTER 4 IMAGING OF THE THYROID 21 Alka Ashmita Singhal CHAPTER 5 PATHOLOGY OF THE THYROID 45 R. Ravi CHAPTER 6 MEDICAL MANAGEMENT OF THYROID DISORDERS 51 Himanshu Patil and Shailesh Pitale CHAPTER 7 ANESTHESIA FOR THYROID SURGERY 57 Vidula Kapre, Shubhada Deshmukh, Pratibha Deshmukh, Meghna Sarode, and Rajashree Chaudhary CHAPTER 8 SAFE THYROIDECTOMY 67 Madan Laxman Kapre, Sankar Viswanath, Rajendra Deshmukh, and Neeti Kapre Gupta CHAPTER 9 SURGERY FOR MULTINODULAR GOITER 75 Madan Laxman Kapre, Sanoop Elambassery, Neeti Kapre Gupta, M. Abdul Amjad Khan, and Gauri Kapre Vaidya CHAPTER 10 MANAGEMENT OF RETROSTERNAL GOITER 79 Belayat Hossain Siddiquee CHAPTER 11 REMOTE ACCESS ENDOSCOPIC AND ROBOTIC THYROIDECTOMY 83 Kyung Tae CHAPTER 12 ROBOTIC THYROIDECTOMY 91 Neil S. Tolley and Christian Camenzuli CHAPTER 13 INTRA-OPERATIVE NEURAL MONITORING 97 Rahul Modi v CHAPTER 14 SURGICAL MANAGEMENT OF DIFFERENTIATED THYROID CANCERS 105 Anil D’cruz and Richa Vaish CHAPTER 15 MANAGEMENT OF NODAL METASTASIS IN THYROID CANCER 113 Neeti Kapre Gupta, Ashok Shaha, Madan Laxman Kapre, Nirmala Thakkar, and Harsh Karan Gupta CHAPTER 16 COMPLICATIONS OF THYROID SURGERY 119 Gregory W. Randolph, Dipti Kamani, Cristian Slough, and Selen Soylu CHAPTER 17 LOCALLY ADVANCED THYROID CANCER 127 Amit Agarwal and Roma Pradhan CHAPTER 18 SURGICAL MANAGEMENT OF MEDULLARY THYROID CANCERS 135 Anuja Deshmukh and Anand Thomas CHAPTER 19 SURGICAL MANAGEMENT OF ANAPLASTIC THYROID CANCERS 147 Deepa Nair and K.S. Rathan Shetty CHAPTER 20 POST-TREATMENT SURVEILLANCE OF THYROID CANCER 151 Abhishek Vaidya CHAPTER 21 A PPLICATIONS OF RADIOISOTOPES IN THE DIAGNOSIS AND TREATMENT OF THYROID DISORDERS 161 Chandrasekhar Bal, Meghana Prabhu, Dhritiman Chakraborty, K. Sreenivasa Reddy, and Saurabh Arora CHAPTER 22 SYSTEMIC THERAPY (TARGETED THERAPY AND IMMUNOTHERAPY) FOR THYROID CANCERS 173 Abhishek Vaidya and Amol Dongre CHAPTER 23 SURGICAL MANAGEMENT OF PARATHYROID DISORDERS 179 Neeti Kapre Gupta, Gregory W. Randolph, and Dipti Kamani CHAPTER 24 PEDIATRIC THYROID SURGERY 187 Rajendra Saoji Index 191 vi Contents PREFACE The seeds of this book were sown by the students getting off the bus It was then that, quite unexpectedly, Miss Shivangi from Taylor & returning from their annual Thyroid Surgical Camp of Chikhaldara, Francis approached us and very kindly offered to take the thread of Melghat. Armed with the art and craft of thyroid surgery, they this new book forward. wanted more insight into the science of it. I soon realized the magnitude of the task. Some unforeseen health Our first book Atlas of Thyroid Surgery answered the question of issues almost stalled the process, and I am grateful to my publishers “how?” but there were more questions, like “when?,” “why?,” and for graciously bearing with the delay. “how much?” that remained unanswered. With this book we have endeavored to bring forth a blend of Thyroid surgery has undergone several paradigm shifts, from being surgical rationale, multidisciplinary decision-making, basic surgical a life-threatening exercise to a minimally invasive procedure. More principles, and techniques for both the novice and the expert alike. than any other surgery, it highlights the need to respect tissues, We have tried to include authors from across the globe to present a nerves, and vessels. Skill, precision, and the fine line between holistic viewpoint on thyroid management. aggression and conservatism in surgery is nowhere as important as Thyroid surgery can be performed with some grams of steel but it is in the management of thyroid disease. To do justice to all this needs nerves of steel. was well beyond the scope of an atlas or a workshop. vii ACKNOWLEDGMENTS What worth is your knowledge if it does not dispel the darkness how difficult it must have been for them to draw that extra ounce of of ignorance? What worth is your skill if it does not make others energy and precious time to painstakingly write their chapters. I am skillful? What worth is a teacher’s greatness if their students do not grateful to all of them. become greater than themselves? And I wish to express my gratitude to my colleagues in my own I have been fortunate to find worthy colleagues, “Men and Women institute, fellows who worked with us, and the secretarial backup of Wisdom,” and worthy publishers, CRC Press, Taylor & Francis I received. Running the risk of missing a few names inadvertently Group, who came together to disseminate the wisdom, skill, and and asking for their pardon, I am grateful to my fellows who have great clinical prowess in the field of thyroid surgery. been burdened by tasks beyond their working hours. Dr. Neeti has been great in gathering bits and pieces provided by Amjad, First, I wish to thank Miss Shivangi Pramanik and Miss Himani Sankar, Sanoop, Shripal, and Priya. She has been my real support Dwivedi who had the faith and patience to bear with us, the authors in compiling this book. and the editor. It was their disciplined approach that laid the foundation for this book, given to us by the publisher CRC Press, Finally, I am in great debt to my family, my wife Vidula, my Taylor & Francis Group. daughters Neeti and Gauri, and my sons-in-law Abhishek and Harsh for their unconditional support and sufferings in the making All my colleague authors who penned the chapters are the worthy of this book. men and women of wisdom. I am appreciative and conscious of ix