Computed Tomography Findings for Diagnosing Follicular Thyroid Neoplasms.

Since no diagnostic method has been established to distinguish follicular thyroid carcinoma (FTC) from follicular thyroid adenoma (FTA), surgery has been the only way to reach a diagnosis of follicular neoplasm. Here we investigated the computed tomography (CT) features of follicular neoplasms, toward the goal of being able to identify specific CT features allowing the preoperative differentiation of FTC from FTA. We retrospectively analyzed the cases of 205 patients who underwent preoperative CT of the neck and were histopathologically diagnosed with FTC (n=31) or FTA (n=174) after surgery between January 2002 and June 2016 at several hospitals in Japan. In each of these 205 cases, non-enhanced and contrast-enhanced CT images were obtained, and we analyzed the CT features. On univariate analysis, inhomogeneous features of tumor lesions on contrast-enhanced CT were more frequently observed in FTC than in FTA (p=0.0032). A multivariate analysis identified inhomogeneous features of tumor lesions on contrast-enhanced CT images as an independent variable indicative of FTC (p=0.0023). CT thus offers diagnostic assistance in distinguishing FTC from FTA.

Clinical evaluation of gasless endoscopic thyroid surgery.

PURPOSE: To determine the feasibility of gasless endoscopic thyroid surgery becoming a standard thyroid operation. METHODS: We retrospectively examined the surgical results of 191 patients who underwent thyroid operations at our hospital between December 1999 and June 2003. We also conducted a survey based on a questionnaire sent to 150 patients who underwent thyroid surgery between December 1999 and September 2002. RESULTS: Although gasless endoscopic thyroid surgery took significantly longer to perform than conventional open surgery, the postoperative stay was significantly shorter and patients had fewer complaints about their surgical scar. CONCLUSIONS: These results indicate that although there are some challenges to overcome, especially the long operative time, gasless endoscopic thyroid surgery could become a standard procedure.

The use of totally extraperitoneal endoscopic hernioplasty for the treatment of groin hernia.

PURPOSE: To examine the use of totally extraperitoneal endoscopic hernioplasty (TEP) and its postoperative complications in order to obtain better and more stable treatment results. METHODS: We studied 73 patients (83 cases) for whom TEP was performed at our hospital between June 1995 and February 2003. The types of hernias included unilateral hernia (63), 10 bilateral hernias, 47 indirect inguinal hernias, 29 direct inguinal hernias, and 7 other types. RESULTS: The average body mass index was 22.3 kg/m2. The average duration of operation was 87.1 +/- 31.1 min for unilateral hernias and 106.5 +/- 38.4 min for bilateral hernias. The length of hospitalization was 9.46 days on average, and the postoperative stay was approximately 6.21 days. 80.8% of all cases were administered analgesics for 1.3 days on average. Postoperative complications were observed in 12 cases: peritoneum injury (3), postoperative subcutaneous suggillation (2), ischemic orchitis (1), and other symptoms which required a switch to other operational techniques (7). CONCLUSION: The study revealed that patients with previous abdominal surgery and patients 70 years of age or older tended to show significantly more postoperative complications and thus, for these patients, the use of TEP should be determined only after careful consideration.