TY - JOUR
T1 - Total thyroidectomy for pressure symptoms in patients with Hashimoto's thyroiditis
AU - Heggie, Katrina
AU - Yeung, Meei
AU - Grodski, Simon
AU - Lee, James
AU - Serpell, Jonathan
PY - 2018/4
Y1 - 2018/4
N2 - Background: Hashimoto's thyroiditis (HT) is rarely on its own the indication for thyroidectomy. However, surgery in patients with HT will be undertaken when there is malignancy and may be required for pressure symptoms. Therefore, this study aimed to investigate the indications for surgery in HT patients. Methods: The Monash University Endocrine Surgery Database was analysed from 1994 to 2013 for patients with HT. Patients with HT were compared to a similar group of patients with no HT on histopathology. Patient demographics, indication for surgery, histopathology, gland weight and complications were analysed. Results: A total of 2346 patients underwent total thyroidectomy during the study period. The median age was 55 years. Eleven percent of patients had HT on final pathology (259/2346). HT patients reported more pressure symptoms, 25.5% compared to those with other pathology, 18.9% (P=0.01). Patients with pressure symptoms had heavier glands, 113g compared to 85g in those with other indications for surgery (P=0.048). Within the HT cohort, the median gland weight was 66g compared to 93g in those without HT (P<0.01). On multivariate analysis, pressure symptoms as an indication for surgery was associated with HT (P<0.01), but age, gender and gland weight were not associated. In patients operated for pressure with HT as the only pathology, 90% had relief of pressure symptoms. Conclusion: Patients with HT were more likely to have pressure symptoms as an indication for surgery independent of gland weights.
AB - Background: Hashimoto's thyroiditis (HT) is rarely on its own the indication for thyroidectomy. However, surgery in patients with HT will be undertaken when there is malignancy and may be required for pressure symptoms. Therefore, this study aimed to investigate the indications for surgery in HT patients. Methods: The Monash University Endocrine Surgery Database was analysed from 1994 to 2013 for patients with HT. Patients with HT were compared to a similar group of patients with no HT on histopathology. Patient demographics, indication for surgery, histopathology, gland weight and complications were analysed. Results: A total of 2346 patients underwent total thyroidectomy during the study period. The median age was 55 years. Eleven percent of patients had HT on final pathology (259/2346). HT patients reported more pressure symptoms, 25.5% compared to those with other pathology, 18.9% (P=0.01). Patients with pressure symptoms had heavier glands, 113g compared to 85g in those with other indications for surgery (P=0.048). Within the HT cohort, the median gland weight was 66g compared to 93g in those without HT (P<0.01). On multivariate analysis, pressure symptoms as an indication for surgery was associated with HT (P<0.01), but age, gender and gland weight were not associated. In patients operated for pressure with HT as the only pathology, 90% had relief of pressure symptoms. Conclusion: Patients with HT were more likely to have pressure symptoms as an indication for surgery independent of gland weights.
KW - Autoimmune thyroiditis
KW - Chronic lymphocytic thyroiditis
KW - Hashimoto's thyroiditis
KW - Lymphocytic thyroiditis
KW - Thyroidectomy
UR - http://www.scopus.com/inward/record.url?scp=85017539325&partnerID=8YFLogxK
U2 - 10.1111/ans.13943
DO - 10.1111/ans.13943
M3 - Article
AN - SCOPUS:85017539325
VL - 88
SP - 359
EP - 362
JO - ANZ Journal of Surgery
JF - ANZ Journal of Surgery
SN - 1445-1433
IS - 4
ER -