Difficult Decisions in Endocrine Surgery

Description:

This book provides a comprehensive overview of difficult decisions encountered within endocrine surgery. Brief uniformly formatted chapters are devoted to answering specific questions relevant to a range of topics across endocrine surgery based upon detailed analysis of available evidence.Topics covered include clinical decision analysis, decision making from the surgeon’s and patient’s perspective, using surgery as opposed to observation for papillary thyroid microcarcinoma, and the use of parathyroid cryopreservation.  Difficult Decisions in Endocrine Surgery: An Evidence-Based Approach features a wealth of information on ideal approaches for making clinical decisions in selected clinical situations. It is an important and timely resource for all endocrine surgical trainees, fellows, practitioners, educators, and healthcare providers involved in the management of these patients.

Table of Contents:

1. Evidence-Based Medicine and the GRADE Approach

2. Clinical Decision Analysis

3. Decision-Making from the Surgeon’s Perspective

4. Involving Patients in Difficult Decisions About Having Surgery

5. Surgery vs Active Surveillance for Low-Risk Papillary Thyroid Carcinoma

6. Prospective Screening Protocol for FNMTC Family Members: Ultrasound Versus Physical Examination

7. Operative Management Versus Observation for Thyroid Nodules Larger than 4 cm with Benign Cytology

8. Lobectomy Versus Total Thyroidectomy for Follicular Microcarcinomas

9. Initial Total Thyroidectomy Versus Lobectomy with Intraoperative Frozen Section for Thyroid Nodules That Are “Suspicious for PTC”

10. Primary Repair Versus No Repair for Transected Recurrent Laryngeal Nerve

11. Surgery Versus Observation for Papillary Thyroid Microcarcinoma

12. First-Line Therapy for Anaplastic Thyroid Cancer: Operation Versus Medical Management

13. Same-Day Versus Overnight Inpatient Surgery for Total Thyroidectomy

14. Prophylactic Versus Selective Central Neck Dissection in Pediatric Papillary Thyroid Cancer

15. Subtotal Parathyroidectomy Versus Total Parathyroidectomy with Autotransplantation for Patients with Multiple Endocrine Neoplasia 1 and Primary Hyperparathyroidism

16. Four-Gland Exploration Versus Four-Dimensional Computed Tomography in Patients with Nonlocalized Primary Hyperparathyroidism

17. Lymph Node Dissection Versus No Lymph Node Dissection for Parathyroid Cancer

18. Early Versus Late Parathyroidectomy for Tertiary (Posttransplant) Hyperparathyroidism

19. Observation Versus Surgery for Pregnant Patients with Primary Hyperparathyroidism

20. Four-Gland Exploration Versus Focused Parathyroidectomy for Hyperparathyroidism Jaw Tumor Syndrome

21. Long-Term Success of Surgery for Primary Hyperparathyroidism: Focused Exploration using Intraoperative Parathyroid Hormone Monitoring Versus Four-Gland Exploration

22. The Evidence for and Against Parathyroid Cryopreservation: Should We Continue to Promote Parathyroid Cryopreservation?

23. Should Antibiotic Prophylaxis Be Given Prior to Thyroidectomy or Parathyroidectomy?

24. The Value of Intraoperative Parathyroid Hormone Monitoring in Primary Hyperparathyroidism Cases That Are Localized with Two Imaging Studies

25. Transperitoneal Versus Retroperitoneal Laparoscopic Adrenalectomy

26. Bilateral Adrenalectomy Versus Medical Management for Cushing’s Syndrome with Bilateral Adrenal Hyperplasia

27. Routine Screening for Primary Hyperaldosteronism in Hypertensive Patients: Yes or No?

28. Routine Glucose Monitoring in Postoperative Pheochromocytoma Patients: Yes or No?

29. Surgical Versus Nonsurgical Management of Malignant Pheochromocytoma

30. Alpha Blocker Versus Calcium Channel Blocker for Pheochromocytoma

31. Surgery Versus Nonsurgical Therapy for Recurrent Adrenocortical Carcinoma

32. Resection Versus Observation for Adrenal Gland Metastasis

33. Routine Versus Selective Adrenal Vein Sampling for Primary Aldosteronism

34. Surgery Versus Observation for Asymptomatic Nonfunctioning Pancreatic Neuroendocrine Tumors

35. Routine Lymph Node Dissection Versus Duodenal Inspection Alone for the Treatment of Multiple Endocrine Neoplasia Type 1 Patients with Hypergastrinemia

36. Resection Versus Chemotherapy for Metastatic Neuroendocrine Tumors of the Pancreas

37. Observation Versus Surgery for Nonlocalized Insulinoma