In endocrine surgery, a precise ultrasonographic measurement of thyroid volume is crucial. However, there is limited comparative research between ultrasonographic and specimen volumes, which has left this issue open to debate. This study aims to assess the accuracy of recommended formulas for ultrasonographic thyroid volume measurement by comparing them to specimen volumes and analyzing the influencing variables. From the data of 120 eligible patients, different formulas, including ultrasonographic thyroid volume (US-TV) based on the ellipsoid formula, lower correction factor thyroid volume (LCF-TV), and calculated ultrasonographic (derived formula) thyroid volume (CU-TV), were used to estimate the thyroid volume based on measurements taken prior to surgery. These measurements were compared with the intraoperative specimen volume (IO-TV) derived using Archimedes’ principle. According to our findings, the mean values for US-TV and LCF-TV were significantly lower, whereas CU-TV was higher than IO-TV. Deviations were more significant in patients who had surgery for benign indications or compressive symptoms and in those with suppressed thyroid-stimulating hormone levels. Although the ellipsoid formula tends to underestimate the actual thyroid volume, it remains the most accurate method for measuring ultrasonographic thyroid volume. The deviation is greater for larger volumes.

Postoperative hypocalcemia is one of the major concerns following thyroidectomy and the most frequent cause of prolonged hospital stay. The aim of this study was to evaluate the relationship between body composition parameters and symptomatic hypocalcemia following total thyroidectomy. In addition, the effects of disease- and patient-related factors on hypocalcemia were investigated. A total of 144 patients were prospectively included between March 2014 and September 2017. Patients were divided into 2 groups according to the presence or absence of clinical symptoms of hypocalcemia. Subsequently, the relationship between body composition parameters and hypocalcemia was evaluated. Postoperative hypocalcemia-related symptoms occurred in 28 patients (19.4%). Permanent hypocalcemia was not encountered in any patient. Patients with hypocalcemic symptoms were more likely to have nodules ≥40 mm (39.3% vs. 17.2%, P = .011), retrosternal goiters (25.0% vs. 7.8%, P = .017), central lymph node dissection (LND) (32.1% vs. 11.2%, P = .015), and parathyroid autotransplantation (28.6% vs. 3.4%, P < .001) than those without symptoms. However, no differences were observed in the body composition parameters between symptomatic and asymptomatic patients. On multivariate analysis, lower preoperative intact parathyroid hormone (iPTH) levels (odds ratios (ORs) .96, 95% confidence intervals (CIs) .93-.99), the presence of retrosternal goiters (OR 10.26, 95% CI 2.23-47.14), central LND (OR 16.05, 95% CI 3.90-66.07), and parathyroid autotransplantation (OR 36.22, 95% CI 6.76-194.13) predicted hypocalcemia. This study demonstrates that patients with lower preoperative iPTH levels, retrosternal goiters, central LND, and parathyroid autotransplantation are at an increased risk of developing clinical symptoms of hypocalcemia. Body composition parameters have no effect on the incidence of hypocalcemia after total thyroidectomy.

Background: Staple-line leak is the most frightening complication of laparoscopic sleeve gastrectomy and several predisposing factors such as using improper staple sizes regardless of gastric wall thickness, narrower bougie diameter and ischemia of the staple line are asserted. Aims: The goal of this study was to evaluate the effects of different bougie diameters on tissue oxygen partial pressure at the esophagogastric junction after sleeve gastrectomy. Study Design: The study was designed as a randomized and controlled animal experiment with 1:1:1:1 allocation ratio. Methods: Thirty-two male Wistar Albino rats were randomly divided into 4 groups of 8 each. While 12 Fr bougies were used in groups 1 and 3, 8 Fr bougies were used in groups 2 and 4. Fibrin sealant application was also carried out around the gastrectomy line after sleeve gastrectomy in groups 3 and 4. Burst pressure of gastrectomy line, tissue oxygen partial pressure (PtO2) and hydroxyproline levels at the esophagogastric junction were measured and compared among groups. Results: Mortality was detected in 2 out of 32 rats (6.25%) and one of them was in group 2 and the cause of this mortality was gastric leak. Gastric leak was detected in 2 out of 32 rats (6.25%). There was no significant difference in terms of burst pressures, PtO2 and tissue hydroxyproline levels among the 4 groups. Conclusions: We conclude that the use of narrower bougie sizes and fibrin sealant do not have any effect on tissue perfusion and wound healing after sleeve gastrectomy.