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1. Impact of the COVID-19 pandemic on surgery for thyroid cancer in Italy: nationwide retrospective study

Author

Medas, F., Ansaldo, G. L., Avenia, N., Basili, G., Bononi, M., Bove, A., Carcoforo, P., Casaril, A., Cavallaro, G., Conzo, G., De Pasquale, L., Del Rio, P., Dionigi, G., Dobrinja, C., Docimo, G., Graceffa, G., Iacobone, M., Innaro, N., Lombardi, C. P., Novelli, G., Palestini, N., Pedicini, F., Perigli, G., Pezzolla, A., Pezzullo, L., Scerrino, G., Spiezia, S., Testini, M., Calo, P. G., Anedda, G., Antonelli, G., Arrigoni, G., Badii, B., Bonati, E., Boniardi, M., Bulfamante, A. M., Candalise, V., Cangiano, A., Canu, G. L., Cappellacci, F., Caracciolo, A., Caruso, E., Casal Ide, E., Chiappini, A., Chiofalo, M. G., Cipolla, C., Costigliola, L., Cozzani, F., Crocco, A., Crocetti, D., De Manzini, N., DI Gioia, A., DI Resta, V., Eramo, R., Erdas, E., Ferriolo, S., Filardo, M., Filograna Pignatelli, M., Gervasi, R., Giudici, F., Gordini, L., Gurrado, A., Impellizzeri, H., Inama, M., Koleva Radica, M., Laforgia, R., Lattarulo, S., Loderer, T., Lucchini, R., Mascioli, F., Marcellinaro, R., Menditto, R., Melfa, G., Minuto, M., Misso, C., Offi, C., Orlando, G., Ossola, P., Pagetta, C., Pasculli, A., Patrone, R., Pauna, I., Pennetti Pennella, F., Pietrasanta, D., Pino, A., Pinto, V. L., Piras, S., Polistena, A., Portinari, M., Reina, S., Rotolo, G., Russo, G., Scalise, E., Sgaramella, L. I., Sibilla, M. G., Spinelli, S., Spoletini, D., Curto, L. S., Tascone, M., Torresan, F., Varaldo, E., Viviani, E., Zucca, A., Medas, F, Ansaldo, G L, Avenia, N, Basili, G, Bononi, M, Bove, A, Carcoforo, P, Casaril, A, Cavallaro, G, Conzo, G, De Pasquale, L, Del Rio, P, Dionigi, G, Dobrinja, C, Docimo, G, Graceffa, G, Iacobone, M, Innaro, N, Lombardi, C P, Novelli, G, Palestini, N, Pedicini, F, Perigli, G, Pezzolla, A, Pezzullo, L, Scerrino, G, Spiezia, S, Testini, M, Calò, P G, Cipolla C, Medas, F., Ansaldo, G. L., Avenia, N., Basili, G., Bononi, M., Bove, A., Carcoforo, P., Casaril, A., Cavallaro, G., Conzo, G., De Pasquale, L., Del Rio, P., Dionigi, G., Dobrinja, C., Docimo, G., Graceffa, G., Iacobone, M., Innaro, N., Lombardi, C. P., Novelli, G., Palestini, N., Pedicini, F., Perigli, G., Pezzolla, A., Pezzullo, L., Scerrino, G., Spiezia, S., Testini, M., Calo, P. G., Anedda, G., Antonelli, G., Arrigoni, G., Badii, B., Bonati, E., Boniardi, M., Bulfamante, A. M., Candalise, V., Cangiano, A., Canu, G. L., Cappellacci, F., Caracciolo, A., Caruso, E., Casal Ide, E., Chiappini, A., Chiofalo, M. G., Cipolla, C., Costigliola, L., Cozzani, F., Crocco, A., Crocetti, D., De Manzini, N., DI Gioia, A., DI Resta, V., Eramo, R., Erdas, E., Ferriolo, S., Filardo, M., Filograna Pignatelli, M., Gervasi, R., Giudici, F., Gordini, L., Gurrado, A., Impellizzeri, H., Inama, M., Koleva Radica, M., Laforgia, R., Lattarulo, S., Loderer, T., Lucchini, R., Mascioli, F., Marcellinaro, R., Menditto, R., Melfa, G., Minuto, M., Misso, C., Offi, C., Orlando, G., Ossola, P., Pagetta, C., Pasculli, A., Patrone, R., Pauna, I., Pennetti Pennella, F., Pietrasanta, D., Pino, A., Pinto, V. L., Piras, S., Polistena, A., Portinari, M., Reina, S., Rotolo, G., Russo, G., Scalise, E., Sgaramella, L. I., Sibilla, M. G., Spinelli, S., Spoletini, D., Curto, L. S., Tascone, M., Torresan, F., Varaldo, E., Viviani, E., and Zucca, A.

Subjects
2019-20 coronavirus outbreak, medicine.medical_specialty, AcademicSubjects/MED00910, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), pandemics, NO, Pandemic, Research Letter, medicine, humans, Thyroid cancer, Thyroid Neoplasm, LS7_4, Thyroid Neoplasms, Thyroidectomy, SARS-CoV-2, COVID-19, Pandemics, Italy, business.industry, thyroid neoplasms, Retrospective cohort study, medicine.disease, Comorbidity, comorbidity, retrospective studies, thyroidectomy, Settore MED/18 - Chirurgia Generale, Emergency medicine, Surgery, AcademicSubjects/MED00010, business
Abstract

N/A

Published
2021

2. The THYCOVIT (Thyroid Surgery during COVID-19 pandemic in Italy) study: results from a nationwide, multicentric, case-controlled study

Author

Medas, F., Ansaldo, G. L., Avenia, N., Basili, G., Boniardi, M., Bononi, M., Bove, A., Carcoforo, P., Casaril, A., Cavallaro, G., Chiofalo, M. G., Conzo, G., De Pasquale, L., Del Rio, P., Dionigi, G., Dobrinja, C., Docimo, G., Graceffa, G., Iacobone, M., Innaro, N., Lombardi, C. P., Palestini, N., Pedicini, F., Perigli, G., Pezzolla, A., Scerrino, G., Spiezia, S., Testini, M., Calo, P. G., Anedda, G., Antonelli, G., Arrigoni, G., Badii, B., Bonati, E., Bulfamante, A. M., Candalise, V., Cangiano, A., Canu, G. L., Cappellacci, F., Caracciolo, A., Caruso, E., Annamaria, D. A., Ide, E. C., Chiappini, A., Cipolla, C., Costigliola, L., Cozzani, F., Crocco, A., Crocetti, D., Demanzini, N., Digioia, A., Diresta, V., Eramo, R., Erdas, E., Ferriolo, S., Filardo, M., Filograna Pignatelli, M., Gervasi, R., Giudici, F., Gordini, L., Gurrado, A., Impellizzeri, H., Inama, M., Koleva Radica, M., Laforgia, R., Lattarulo, S., Loderer, T., Lucchini, R., Mascioli, F., Marcellinaro, R., Menditto, R., Melfa, G., Minuto, M., Misso, C., Offi, C., Orlando, G., Ossola, P., Pagetta, C., Pasculli, A., Patrone, R., Pauna, I., Pennetti Pennella, F., Pietrasanta, D., Pino, A., Pinto, V. L., Piras, S., Polistena, A., Portinari, M., Reina, S., Rotolo, G., Russo, G., Scalise, E., Sgaramella, L. I., Sibilla, M. G., Spinelli, S., Spoletini, D., Curto, L. S., Tascone, M., Torresan, F., Varaldo, E., Viviani, E., Zucca, A., Medas, Fabio, Ansaldo, Gian Luca, Avenia, Nicola, Basili, Giancarlo, Boniardi, Marco, Bononi, Marco, Bove, Aldo, Carcoforo, Paolo, Casaril, Andrea, Cavallaro, Giuseppe, Chiofalo, Maria Grazia, Conzo, Giovanni, De Pasquale, Loredana, Del Rio, Paolo, Dionigi, Gianlorenzo, Dobrinja, Chiara, Docimo, Giovanni, Graceffa, Giuseppa, Iacobone, Maurizio, Innaro, Nadia, Lombardi, Celestino Pio, Palestini, Nicola, Pedicini, Francesco, Perigli, Giuliano, Pezzolla, Angela, Scerrino, Gregorio, Spiezia, Stefano, Testini, Mario, Calò, Pietro Giorgio, Calogero, Cipolla, Medas, F., Ansaldo, G. L., Avenia, N., Basili, G., Boniardi, M., Bononi, M., Bove, A., Carcoforo, P., Casaril, A., Cavallaro, G., Chiofalo, M. G., Conzo, G., De Pasquale, L., Del Rio, P., Dionigi, G., Dobrinja, C., Docimo, G., Graceffa, G., Iacobone, M., Innaro, N., Lombardi, C. P., Palestini, N., Pedicini, F., Perigli, G., Pezzolla, A., Scerrino, G., Spiezia, S., Testini, M., Calo, P. G., Anedda, G., Antonelli, G., Arrigoni, G., Badii, B., Bonati, E., Bulfamante, A. M., Candalise, V., Cangiano, A., Canu, G. L., Cappellacci, F., Caracciolo, A., Caruso, E., Annamaria, D. A., Ide, E. C., Chiappini, A., Cipolla, C., Costigliola, L., Cozzani, F., Crocco, A., Crocetti, D., Demanzini, N., Digioia, A., Diresta, V., Eramo, R., Erdas, E., Ferriolo, S., Filardo, M., Filograna Pignatelli, M., Gervasi, R., Giudici, F., Gordini, L., Gurrado, A., Impellizzeri, H., Inama, M., Koleva Radica, M., Laforgia, R., Lattarulo, S., Loderer, T., Lucchini, R., Mascioli, F., Marcellinaro, R., Menditto, R., Melfa, G., Minuto, M., Misso, C., Offi, C., Orlando, G., Ossola, P., Pagetta, C., Pasculli, A., Patrone, R., Pauna, I., Pennetti Pennella, F., Pietrasanta, D., Pino, A., Pinto, V. L., Piras, S., Polistena, A., Portinari, M., Reina, S., Rotolo, G., Russo, G., Scalise, E., Sgaramella, L. I., Sibilla, M. G., Spinelli, S., Spoletini, D., Curto, L. S., Tascone, M., Torresan, F., Varaldo, E., Viviani, E., and Zucca, A.

Subjects
COVID-19, Endocrine surgery, SARS-CoV-2, Thyroid carcinoma, Thyroidectomy, medicine.medical_specialty, medicine.medical_treatment, Thyroid Gland, Humans, Italy, Retrospective Studies, Pandemics, NO, Retrospective Studie, Pandemic, Epidemiology, medicine, Thyroid cancer, LS7_4, business.industry, Thyroid disease, Case-control study, Retrospective cohort study, medicine.disease, Surgery, Original Article, business, Human
Abstract

The outbreak of the COVID-19 pandemic has led to a disruption of surgical care. The aim of this multi-centric, retrospective study was to evaluate the impact of the pandemic on surgical activity for thyroid disease among the Italian Units of Endocrine Surgery. Three phases of the pandemic were identified based on the epidemiological situation and the public measures adopted from the Italian Government (1st phase: from 9th March to 3rd May 2020; 2nd phase: from 4th May to 14th June; 3rd phase: from 15th June to 31st). The patients operated upon during these phases were compared to those who underwent surgery during the same period of the previous year. Overall, 3892 patients from 28 Italian endocrine surgical units were included in the study, 1478 (38%) operated upon during COVID-19 pandemic, and 2414 (62%) during the corresponding period of 2019. The decrease in the number of operations was by 64.8%, 44.7% and 5.1% during the three phases of COVID-19 pandemic, compared to 2019, respectively. During the first and the second phases, the surgical activity was dedicated mainly to oncological patients. No differences in post-operative complications were noted between the two periods. Oncological activity for thyroid cancer was adequately maintained during the COVID-19 pandemic.

Published
2021

3. Thyroid-Bed Schwannoma Mimicking a Thyroid Neoplasm: A Challenging Diagnosis: Report of a Case and Literature Review

Author

Claudio Gambardella, Ludovico Docimo, Giancarlo Candela, Giovanni Cozzolino, Federico Mongardini, Francesca Serilli, Giusiana Nesta, Marcello Filograna Pignatelli, Sonia Ferrandes, Antonio Gambardella, Giovanni Docimo, Gambardella, C., Docimo, L., Candela, G., Cozzolino, G., Mongardini, F., Serilli, F., Nesta, G., Filograna Pignatelli, M., Ferrandes, S., Gambardella, A., and Docimo, G.

Subjects
total thyroidectomy, Male, thyroid ma, Thyroidectomy, Humans, General Medicine, Thyroid Neoplasms, Neurilemmoma, Neck, neck neoplasm, neck schwannoma, thyroid-bed lesion, Aged
Abstract

Background: Schwannomas, also called neurinomas, are rare benign tumors of the neural cells that can develop from the sheaths of nervous structures of several districts, although the most frequent sites are the cranial nerves (25%–45%). Rarely, cases show neck schwannomas in the thyroid parenchyma, while the cases of thyroid-bed schwannomas mimicking a thyroid-gland lesions are anecdotal. Methods: We report the case of a 70-year-old man with a preoperative-imaging diagnosis of a thyroid neoplasm, confirmed as Thyr 4 by fine-needle cytology. Results: During surgery, an extra-thyroidal lesion was discovered, determined to be a neck schwannoma through definitive pathology. A literature review of cases of thyroid-bed-lesion schwannomas misinterpreted as thyroid neoplasms was carried out. Conclusions: In the case of suspicious extra-thyroidal lesions, we advocate for a close routine cooperation between the cytologist, the radiologist, and the surgeon in the attempt to reach an accurate preoperative diagnosis.

Published
2022

4. Adherence to Mediterranean diet and prevalence of differentiated thyroid cancer: a single-center Unit of Thyroid Surgery experience in a Southern-Italy cohort.

Author

Monaco A, Verde L, Filograna Pignatelli M, Docimo A, Ferrandes S, Barrea L, Calisti F, Cozzolino G, Muscogiuri G, and Docimo G

Abstract

Background: The Mediterranean diet (MD) is recognized as a cultural heritage by UNESCO, thus, is a nutritional model widely spread in all Mediterranean countries. As already demonstrated by several studies, high adherence to MD is a protective factor against many chronic diseases. Conversely, poor adherence to the diet is correlated with an increased prevalence of these pathologies. The aim of the current study was to investigate the relationship between the adherence to MD and the prevalence of benign and malignant thyroid disease., Methods: We analyzed the health status of 60 patients, referred to total thyroidectomy and histological examination, due to nodular thyroid disease. Eating habits were evaluated according to the PREDIMED questionnaire, and patients' results were evaluated according to histological findings of benign or malignant disease., Results: PREDIMED Score was lower in patients with malignant thyroid disease (MTD) than those with benign thyroid disease (BTD) (5.27±0.87 vs. 7.00±1.23, respectively; P value <0.001). A significant correlation was found between poor adherence to MD and diagnosis of MTD (r=0.454; P<0.001). Excessive consumption of butter and sugary drinks, along with low consumption of pasta, white meat, and rice were found to be predictive factors of MTD., Conclusions: In our cohort, a PREDIMED Score ≤7 resulted significantly related to MTD diagnosis, while a good adherence to MD resulted associated with BTD. Moreover, high consumption of sweetened beverages seemed to predict MTD histologic diagnosis, while, conversely, low consumption resulted predictor of BTD. Nevertheless, more studies are needed to evaluate the effective impact of MD on MTD incidence on larger cohorts.

Published
2024
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5. Role of Absorbable Polysaccharide Hemostatic Powder in the Prevention of Bleeding and Wound Events after Thyroid Surgery.

Author

Docimo G, Filograna Pignatelli M, Ferrandes S, Monaco A, Calisti F, Ruggiero R, Tolone S, Lucido FS, Brusciano L, Parisi S, Conzo G, Docimo L, and Gambardella C

Abstract

Background: Bleeding is one of the most fearsome and life-threatening complications after thyroid surgery. Several medical devices and haemostatic agents have been proposed to improve haemostasis during total and hemi-thyroidectomy. Resorbable polysaccharide powder (HaemoCer™) is a plant-based polymer that is helpful in terms of the coagulation cascade becoming a gel and forming a barrier to prevent further bleeding, having tested for haemostasis in different districts. The aim of the current study was the evaluation of drain output, the presence of significant postoperative blood loss and complications in patients treated with or without resorbable polysaccharide powder during thyroid surgery., Methods: From January to December 2022, postoperative bleeding, drainage output and the postoperative wound events of patients undergoing thyroid surgery, in a tertiary centre, with haemostasis completion with resorbable polysaccharide powder (Group A) or not (Group B), were retrospectively analysed., Results: Eighty-one patients in Group A received a haemostasis improvement with the use of reabsorbable polysaccharide powder, and 96 patients in Group B received thyroid surgery alone. Patients in Group A presented lower drainage output (0.005), lower incidence of neck haematoma (0.005) and seroma (0.021), confirmed also by multivariate analysis., Conclusions: The resorbable polysaccharide powder, in the current series, appeared to be an effective agent in achieving haemostasis in thyroidectomies, reducing the postoperative drainage output, and also neck events such as neck haematoma and seroma, improving the postoperative comfort of the patients. Further larger comparative studies are needed to address this issue.

Published
2023
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6. Thyroid-Bed Schwannoma Mimicking a Thyroid Neoplasm: A Challenging Diagnosis: Report of a Case and Literature Review.

Author

Gambardella C, Docimo L, Candela G, Cozzolino G, Mongardini F, Serilli F, Nesta G, Filograna Pignatelli M, Ferrandes S, Gambardella A, and Docimo G

Subjects
Male, Humans, Aged, Thyroidectomy methods, Neck, Thyroid Neoplasms diagnosis, Thyroid Neoplasms surgery, Neurilemmoma diagnosis, Neurilemmoma pathology, Neurilemmoma surgery
Abstract

Background: Schwannomas, also called neurinomas, are rare benign tumors of the neural cells that can develop from the sheaths of nervous structures of several districts, although the most frequent sites are the cranial nerves (25%-45%). Rarely, cases show neck schwannomas in the thyroid parenchyma, while the cases of thyroid-bed schwannomas mimicking a thyroid-gland lesions are anecdotal., Methods: We report the case of a 70-year-old man with a preoperative-imaging diagnosis of a thyroid neoplasm, confirmed as Thyr 4 by fine-needle cytology., Results: During surgery, an extra-thyroidal lesion was discovered, determined to be a neck schwannoma through definitive pathology. A literature review of cases of thyroid-bed-lesion schwannomas misinterpreted as thyroid neoplasms was carried out., Conclusions: In the case of suspicious extra-thyroidal lesions, we advocate for a close routine cooperation between the cytologist, the radiologist, and the surgeon in the attempt to reach an accurate preoperative diagnosis.

Published
2022
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7. Evaluation of LMR, NLR and PLR as predictors of malignancy in indeterminate thyroid nodules.

Author

Offi C, Romano RM, Cangiano A, Filograna Pignatelli M, Candela G, and Docimo G

Subjects
Humans, Lymphocytes, Monocytes, Retrospective Studies, Neutrophils, Thyroid Nodule diagnosis
Abstract

Objective: Thyroid nodules with indeterminate cytology represent 20% of all thyroid nodules. Inflammation plays an important role in cancer. Lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are independent prognostic scores in numerous cancers, although no study has documented their role in cytology indeterminate nodules. The aim of this study is to evaluate the role of LMR, NLR and PLR values as predictors of malignancy in patients with cytology indeterminate nodules., Methods: This retrospective study analysed data from 298 patients with indeterminate thyroid nodule. Anatomopathological and haematological data were analysed, dividing the population into two groups. LMR, NLR and PLR values were determined using ROC curve and data were analysed using independent samples t-test, test of proportions, Fisher's exact test and univariate and multivariate logistic regression., Results: We found that a baseline LMR value ≥ 4.09 was indicative of benignity of indeterminate nodule. The probability of malignancy in patients with LMR < 4.09 was 26 times higher than patients with a LMR value ≥ 4.09., Conclusions: This study showed that only LMR has shown a concrete probability to find a thyroid cancer in patients with indeterminate nodules. Further studies are necessary to implement tailored treatment., (Copyright © 2021 Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale, Rome, Italy.)

Published
2021
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