A national study of postoperative thyroid hormone supplementation rates after thyroid lobectomy.

Autor: Hu QL; Division of GI/Endocrine Surgery, Columbia University, New York, NY. Electronic address: linaqhu@gmail.com., Chen L; Division of Gynecology, Columbia University, New York, NY., Kuo EJ; Division of GI/Endocrine Surgery, Columbia University, New York, NY., Lee JA; Division of GI/Endocrine Surgery, Columbia University, New York, NY., Kuo JH; Division of GI/Endocrine Surgery, Columbia University, New York, NY., Wright JD; Division of Gynecology, Columbia University, New York, NY., McManus CM; Division of GI/Endocrine Surgery, Columbia University, New York, NY.
Jazyk: angličtina
Zdroj: Surgery [Surgery] 2024 Apr; Vol. 175 (4), pp. 1029-1033. Date of Electronic Publication: 2023 Dec 14.
DOI: 10.1016/j.surg.2023.11.016
Abstrakt: Background: The American Thyroid Association updated guidelines in 2015 to allow lobectomy for low-risk thyroid cancers. The objectives of this study were (1) to determine thyroid hormone supplementation rates after lobectomy and (2) to evaluate the effect of the American Thyroid Association guideline change on lobectomy and hormone supplementation rates among thyroid cancer patients.
Methods: The Merative MarketScan Databases was used to identify adult (≥age 18) patients who underwent thyroidectomy for benign nodules or thyroid cancer. The association between indication for surgery and postoperative thyroid hormone supplementation was examined using χ 2 analyses and multivariable logistic regression models. Among patients with thyroid cancer, lobectomy and hormone supplementation rates were compared in the periods before (2008-2015) and after the guideline change (2016-2019).
Results: Of the 81,926 patients identified, 33,756 (41.2%) underwent thyroid lobectomy, 45,104 (55.1%) underwent total thyroidectomy, and 3,066 (3.7%) underwent completion thyroidectomy. Patients who underwent lobectomy for malignancy were significantly more likely to require hormone supplementation (59.3% vs 39.4% [P < .001], adjusted odds ratio 2.34 [95% confidence interval 2.20-2.48]) compared to those with benign disease. Compared to the 2008 to 2015 period, the proportion of patients who underwent lobectomy for thyroid cancer was higher in the 2016 to 2019 period (34.3% vs 30.3%, P < .001), with fewer patients requiring completion thyroidectomy (25.6% vs 29.8%, P < .001) and thyroid hormone supplementation (56.9% vs 60.1%, P = .04).
Conclusion: The postoperative thyroid hormone supplementation rate was significantly higher in patients who had thyroid cancers compared to benign diseases. After the American Thyroid Association guidelines changed, lobectomy rates increased significantly without a concomitant increase in the completion of thyroidectomy.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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