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Randomized clinical trials

The randomized clinical trials section is produced following a review of the content of the best surgical journals published in English worldwide. The section editor is Jonothan Earnshaw, Director of the BJS Academy and Consultant Vascular Surgeon at Gloucestershire Hospitals NHS Foundation Trust, UK.

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Sternomastoid intermuscular approach has better postoperative cosmesis and less neck discomfort than linea alba cervicalis approach in hemithyroidectomy: a randomized clinical trial.

Chen L, He Q, Tian H, Zhu Q, Shen Y, Fang Y et al.

Int J Surg 2023; 109: 2672-2679.

Two different surgical approaches were assessed in 220 patients having surgery for unilateral thyroid cancer. Both incisions were safe and effective, but the sternomastoid incision resulted in less discomfort in the first month (P=0.02), and improved cosmesis from an observer viewpoint.

Comment: The lateral approach for a hemithyroidectomy could have advantages over the standard transverse incision.

18 December 2023

Randomized clinical trialsEndocrine

Does the use of probe-based near-infrared autofluorescence parathyroid detection benefit parathyroidectomy? A randomized single-center clinical trial.

Kiernan C, Thomas G, Patel A, Fan R, Ye F, Willmon P et al.

Ann Surg 2023; 278: 549-558.

In this study that included 160 procedures, use of the probe improved the parathyroid detection rate by an experienced surgeon (3.6 versus 3.2 per procedure, P<0.001), and reduced the number of frozen section procedures required (17 versus 47, P=0.005). Detection rates were better for trainees than experienced surgeons.

Comment: Useful, but is it generalizable?

6 December 2023

Randomized clinical trialsEndocrine

Prophylactic central neck lymph node dissection in low-risk thyroid carcinoma patients does not decrease the incidence of locoregional recurrence. A meta-analysis of randomized trials.

Sanabria A, Betancourt-Agüero C, Sánchez-Delgado J, García-Lozano C.

Ann Surg 2022; 276: 66-73.

There were five RCTs with 763 treated patients. Rates of recurrence were similar: 2.7 per cent after additional node dissection and 2.5 per cent after thyroidectomy alone. Node dissection increased the rate of permanent hypoparathyroidism: risk difference 3 per cent.

Comment; This result seems definitive.

6 September 2022

Randomized clinical trialsEndocrine

A prospective randomized controlled trial to assess the efficacy and safety of prophylactic central compartment lymph node dissection in papillary thyroid carcinoma.

Ahn J-H, Kwak JH, Yoon SG, Yi JW, Yu HW, Kwon H et al.

Surgery 2022; 171: 182-189.

Central lymph node dissection improved the yield of positive nodes in this study of 101 procedures, without affecting complication rates. No patient had a recurrence up to four years after surgery.

Comment: This study is too small to provide answers in the long term.

17 May 2022

Randomized clinical trialsEndocrine

Academy

Part of the charitable activity of the Foundation, BJS Academy is an online educational resource for current and future surgeons.

The Academy is comprised of five distinct sections: Continuing surgical education, Young BJS, Cutting edge, Scientific surgery and Surgical news. Although the majority of this is open access, additional content is available to BJS subscribers and strategic partners.

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Surgeon Training & Surgeons in Surgery

About BJS Foundation

As a registered charity, BJS Foundation’s mission to improve surgical education is underpinned by its strategic partnerships and its leading surgical journals.

Since its inception in 1913, the readership of BJS has continued to grow across the globe, paving the way for complementary open access journal, BJS Open, in 2017.

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BJS Society Team