Klinik Araştırma
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Surgical outcomes of thyroidectomy patients: Single-center experience

Yıl 2024, Cilt: 17 Sayı: 2, 30 - 35, 01.07.2024

Öz

Thyroid cancer incidence has been on the rise globally, attributed to advancements in detection technologies. Surgical outcomes and complications of thyroidectomy remain debated, with varying evidence on the safety and timing of completion of thyroidectomy. This study aims to retrospectively evaluate thyroidectomy patients at a regional reference clinic, comparing outcomes with existing literature.
A retrospective analysis of 471 thyroidectomy patients (2012-2022) included demographic data, preoperative assessments, and postoperative complications. Data were analyzed using SPSS. Patients with malignancy pathology results were compared with benign cases. Exclusions included those under 18 and reoperated cases.
Females predominated (81.5%), aligning with global trends. Malignant cases had higher rates of AUS-FLUS and follicular neoplasia on FNAB. Postoperative T4 values were significantly higher in benign cases, while TSH values were lower. Vocal cord paralysis occurred in 10.8%, with nerve monitoring reducing permanent damage post-2018.
Demographic findings mirrored global trends, emphasizing the female predominance in seeking thyroidectomy. FNAB effectively predicted malignancy, supporting accurate preoperative assessments. Postoperative thyroid and laboratory values varied between benign and malignant groups, with nerve monitoring reducing permanent damage rates.
Thyroidectomy, a common procedure for thyroid diseases, requires meticulous planning to minimize complications. FNAB results, laboratory values, and nerve monitoring significantly influence outcomes. This study contributes a comprehensive overview of thyroidectomy outcomes, emphasizing the need for careful preoperative assessments and the integration of advanced technologies. The findings prompt further research for a more nuanced understanding of thyroidectomy outcomes.

Etik Beyan

Çalışmamız Muğla Sıtkı Koçman Üniversitesi Tıp Fakültesi Klinik Araştırmalar Etik Kurulundan onay almıştır. 19.12.2022 tarih, no: 220094

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

Değerlendirme sürecindeki katkılarından dolayı değerli editör ekibine ve hakemlerimize şimdiden teşekkür ederim. Saygılarımla.

Kaynakça

  • 1. Jegerlehner S, Bulliard JL, Aujesky D, et al. Overdiagnosis and overtreatment of thyroid cancer: A population-based temporal trend study. PloS one, 2017;12(6):e0179387.
  • 2. Zhai M, Zhang D, Long J, et al. The global burden of thyroid cancer and its attributable risk factor in 195 countries and territories: A systematic analysis for the Global Burden of Disease Study. Cancer medicine, 2021;10(13):4542-4554.
  • 3. Tae K, Ji YB, Song CM, et al. Safety and efficacy of transoral robotic and endoscopic thyroidectomy: the first 100 cases. Head & neck, 2020;42(2):321-329.
  • 4. Shulin J, Aizhen J, Kuo SM, et al. Rising incidence of thyroid cancer in Singapore not solely due to micropapillary subtype. The Annals of The Royal College of Surgeons of England, 2018;100(4):295-300.
  • 5. Cheng SYH, YC Hsu, S.-P. Cheng. Trends in thyroid cancer burden in Taiwan over two decades. Cancer Causes & Control, 2023, p:1-9.
  • 6. Veedu JS, Mathew A. Are we missing the elephant in the room? A case for thyroid cancer overdiagnosis as the etiology for its increasing incidence in India. Journal of Global Oncology, 2018;4(10):1-3.
  • 7. Salamat, F, Aryannia A, Rajaei S, et al. Temporal and geographical trends of incidence of thyroid cancer in Golestan, Iran, 2004-2013. Archives of Iranian Medicine, 2021;24(1):1-6.
  • 8. O'Grady TJ, Gates MA, Boscoe FP. Thyroid cancer incidence attributable to overdiagnosis in the United States 1981–2011. International journal of cancer, 2015;137(11):2664-2673.
  • 9. Musbah N, Saad HIF, Mohamed SS. Safety and Effectiveness of Total Thyroidectomy for Benign Multinodular Goitre. Al-Mukhtar Journal of Sciences, 2019;34(4):243-247.
  • 10. Saleem RB, Saleem MB, Saleem NB. Impact of completion thyroidectomy timing on postoperative complications: a systematic review and meta-analysis. Gland Surgery, 2018;7(5):458.
  • 11. Lim H, Devesa SS, Sosa JA, et al. Trends in thyroid cancer incidence and mortality in the United States, 1974-2013. Jama, 2017;317(13):1338-1348.
  • 12. Lee J, Lee HY, Kim WC. Trends in the incidence of thyroid cancer in Incheon Province, South Korea, from 2004 to 2013: A representative sample study from Incheon cancer registry. Asia‐Pacific Journal of Clinical Oncology, 2022;18(5):e398-e403.
  • 13. Piromchai P. Comparison of quality of life between patients undergoing submental endoscopic thyroidectomy and conventional thyroidectomy: A prospective controlled clinical trial. J Clinical Medicine, 2022;11(16):4802.
  • 14. Shin IB, Bae DS. Comparison of the Postoperative Outcomes of the Mini-Flap Bilateral Axillo-Breast Approach (BABA) and Conventional BABA Robot-Assisted Thyroidectomy. Journal of Clinical Medicine, 2022;11(16):4894.
  • 15. Haymart MR, Banerjee M, Reyes-Gastelyum D, et al. Thyroid ultrasound and the increase in diagnosis of low-risk thyroid cancer. The Journal of Clinical Endocrinology & Metabolism, 2019;104(3):785-792.
  • 16. Kasemsiri P, Trakulkajornsak S, Bamroong P, et al. Comparison of quality of life between patients undergoing trans-oral endoscopic thyroid surgery and conventional open surgery. BMC surgery, 2020;20:1-7.
  • 17. Tang J-X, Wang L, Nian W-Q, et al. Asymptomatic carbon dioxide embolism during transoral vestibular thyroidectomy: A case report. World Journal of Clinical Cases, 2021;9(16):4024.
  • 18. Fan L, Meng F, Gao Y, Liu P. Insufficient iodine nutrition may affect the thyroid cancer incidence in China. British Journal of Nutrition, 2021;126(12):1852-1860.
  • 19. Jang J, Yoo DS, Chun BC. Spatial distribution and determinants of thyroid cancer incidence from 1999 to 2013 in Korea. Scientific Reports, 2021;11(1):22474.

Tiroidektomi Hastalarının Cerrahi Sonuçları: Tek Merkez Deneyimi

Yıl 2024, Cilt: 17 Sayı: 2, 30 - 35, 01.07.2024

Öz

Giriş:
Tiroid kanseri insidansı küresel olarak artmaktadır ve bu durum, tespit teknolojilerindeki ilerlemelere bağlanmaktadır. Tiroidektominin cerrahi sonuçları ve komplikasyonları, tamamlanmış tiroidektominin güvenliği ve zamanlaması konularında farklı kanıtların olduğu bir tartışma halindedir. Bu çalışma, bölgesel bir referans kliniğinde tiroidektomi geçirmiş hastaları retrospektif olarak değerlendirmeyi amaçlamaktadır ve sonuçları mevcut literatürle karşılaştırmayı hedeflemektedir.

Yöntem:
2012-2022 yılları arasında 471 tiroidektomi hastasının retrospektif analizi, demografik verileri, preoperatif değerlendirmeleri ve postoperatif komplikasyonları içermiştir. Veriler SPSS kullanılarak analiz edilmiştir. Malign patoloji sonuçlarına sahip hastalar, benign vakalarla karşılaştırılmıştır. 18 yaşın altındakiler ve dış merkezde yeniden ameliyat geçirenler çalışmaya dahil edilmemiştir.

Sonuçlar:
Kadınlar çoğunluktaydı (%81.5) ve bu, küresel eğilimlere uyumlu bir şekildeydi. Malign vakalarda FNAB'da AUS-FLUS ve foliküler neoplazi oranları daha yüksekti. Postoperatif T4 değerleri benign vakalarda anlamlı derecede yüksekken, TSH değerleri düşüktü. Vokal kord paralizisi %10.8 oranında görüldü ve 2018 sonrasında sinir izleme, kalıcı hasarı azalttı.

Tartışma:
Demografik bulgular, kadınların tiroidektomi talebindeki küresel eğilimleri yansıtarak vurgulamıştır. FNAB, maligniteyi etkili bir şekilde öngörmüş ve doğru preoperatif değerlendirmeleri desteklemiştir. Postoperatif tiroid ve laboratuvar değerleri, benign ve malign gruplar arasında değişmiş ve sinir izleme, kalıcı hasarı azaltmıştır.

Sonuç:
Tiroid hastalıklarının yaygın bir tedavi yöntemi olan tiroidektomi, komplikasyonları minimize etmek için dikkatli planlama gerektirmektedir. FNAB sonuçları, laboratuvar değerleri ve sinir izleme, sonuçları önemli ölçüde etkilemektedir. Bu çalışma, tiroidektomi sonuçlarına kapsamlı bir bakış sunmakta ve dikkatli preoperatif değerlendirmelerin ve ileri teknolojilerin entegrasyonunun önemini vurgulamaktadır. Bulgular, tiroidektomi sonuçlarının daha derin bir anlayışını sağlamak için ileri araştırma alanlarını öne çıkarmaktadır.

Proje Numarası

yok

Kaynakça

  • 1. Jegerlehner S, Bulliard JL, Aujesky D, et al. Overdiagnosis and overtreatment of thyroid cancer: A population-based temporal trend study. PloS one, 2017;12(6):e0179387.
  • 2. Zhai M, Zhang D, Long J, et al. The global burden of thyroid cancer and its attributable risk factor in 195 countries and territories: A systematic analysis for the Global Burden of Disease Study. Cancer medicine, 2021;10(13):4542-4554.
  • 3. Tae K, Ji YB, Song CM, et al. Safety and efficacy of transoral robotic and endoscopic thyroidectomy: the first 100 cases. Head & neck, 2020;42(2):321-329.
  • 4. Shulin J, Aizhen J, Kuo SM, et al. Rising incidence of thyroid cancer in Singapore not solely due to micropapillary subtype. The Annals of The Royal College of Surgeons of England, 2018;100(4):295-300.
  • 5. Cheng SYH, YC Hsu, S.-P. Cheng. Trends in thyroid cancer burden in Taiwan over two decades. Cancer Causes & Control, 2023, p:1-9.
  • 6. Veedu JS, Mathew A. Are we missing the elephant in the room? A case for thyroid cancer overdiagnosis as the etiology for its increasing incidence in India. Journal of Global Oncology, 2018;4(10):1-3.
  • 7. Salamat, F, Aryannia A, Rajaei S, et al. Temporal and geographical trends of incidence of thyroid cancer in Golestan, Iran, 2004-2013. Archives of Iranian Medicine, 2021;24(1):1-6.
  • 8. O'Grady TJ, Gates MA, Boscoe FP. Thyroid cancer incidence attributable to overdiagnosis in the United States 1981–2011. International journal of cancer, 2015;137(11):2664-2673.
  • 9. Musbah N, Saad HIF, Mohamed SS. Safety and Effectiveness of Total Thyroidectomy for Benign Multinodular Goitre. Al-Mukhtar Journal of Sciences, 2019;34(4):243-247.
  • 10. Saleem RB, Saleem MB, Saleem NB. Impact of completion thyroidectomy timing on postoperative complications: a systematic review and meta-analysis. Gland Surgery, 2018;7(5):458.
  • 11. Lim H, Devesa SS, Sosa JA, et al. Trends in thyroid cancer incidence and mortality in the United States, 1974-2013. Jama, 2017;317(13):1338-1348.
  • 12. Lee J, Lee HY, Kim WC. Trends in the incidence of thyroid cancer in Incheon Province, South Korea, from 2004 to 2013: A representative sample study from Incheon cancer registry. Asia‐Pacific Journal of Clinical Oncology, 2022;18(5):e398-e403.
  • 13. Piromchai P. Comparison of quality of life between patients undergoing submental endoscopic thyroidectomy and conventional thyroidectomy: A prospective controlled clinical trial. J Clinical Medicine, 2022;11(16):4802.
  • 14. Shin IB, Bae DS. Comparison of the Postoperative Outcomes of the Mini-Flap Bilateral Axillo-Breast Approach (BABA) and Conventional BABA Robot-Assisted Thyroidectomy. Journal of Clinical Medicine, 2022;11(16):4894.
  • 15. Haymart MR, Banerjee M, Reyes-Gastelyum D, et al. Thyroid ultrasound and the increase in diagnosis of low-risk thyroid cancer. The Journal of Clinical Endocrinology & Metabolism, 2019;104(3):785-792.
  • 16. Kasemsiri P, Trakulkajornsak S, Bamroong P, et al. Comparison of quality of life between patients undergoing trans-oral endoscopic thyroid surgery and conventional open surgery. BMC surgery, 2020;20:1-7.
  • 17. Tang J-X, Wang L, Nian W-Q, et al. Asymptomatic carbon dioxide embolism during transoral vestibular thyroidectomy: A case report. World Journal of Clinical Cases, 2021;9(16):4024.
  • 18. Fan L, Meng F, Gao Y, Liu P. Insufficient iodine nutrition may affect the thyroid cancer incidence in China. British Journal of Nutrition, 2021;126(12):1852-1860.
  • 19. Jang J, Yoo DS, Chun BC. Spatial distribution and determinants of thyroid cancer incidence from 1999 to 2013 in Korea. Scientific Reports, 2021;11(1):22474.
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Genel Cerrahi
Bölüm Araştırma Makalesi
Yazarlar

Samet Şahin 0000-0003-0748-3458

Cenk Yazkan 0000-0002-4252-8490

Özcan Dere 0000-0002-5589-4326

Önder Özcan 0000-0001-8252-3339

Proje Numarası yok
Yayımlanma Tarihi 1 Temmuz 2024
Gönderilme Tarihi 16 Aralık 2023
Kabul Tarihi 21 Mart 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 17 Sayı: 2

Kaynak Göster

Vancouver Şahin S, Yazkan C, Dere Ö, Özcan Ö. Surgical outcomes of thyroidectomy patients: Single-center experience. JSurgArts. 2024;17(2):30-5.

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