Postoperative thyroid hormone supplementation rates following thyroid lobectomy
Autor: | Madeleine Wilson, John J. Baker, Zafar Sayed, Abbey L. Fingeret, Whitney Goldner, Anery Patel |
---|---|
Rok vydání: | 2020 |
Předmět: |
Male
endocrine system medicine.medical_specialty Thyroid Hormones Thyroiditis endocrine system diseases Hormone Replacement Therapy medicine.medical_treatment Thyrotropin 030209 endocrinology & metabolism Thyroid Lobectomy Gastroenterology Thyroid carcinoma Cohort Studies 03 medical and health sciences 0302 clinical medicine Thyroid-stimulating hormone Internal medicine medicine Humans Euthyroid Postoperative Period Thyroid Neoplasms Thyroid cancer Retrospective Studies Postoperative Care business.industry Thyroid Thyroidectomy General Medicine Middle Aged medicine.disease medicine.anatomical_structure 030220 oncology & carcinogenesis Female Surgery business |
Zdroj: | The American Journal of Surgery. 220:1169-1173 |
ISSN: | 0002-9610 |
Popis: | Thyroid lobectomy is performed for symptomatic benign nodules, indeterminate nodules, or low-risk well-differentiated thyroid cancer. We aimed to determine factors associated with need for thyroid hormone supplementation following thyroid lobectomy.We performed a retrospective single-institution cohort study of patients undergoing thyroid lobectomy from January 2016 to December 2017. Thyroid hormone supplementation was assessed postoperatively based on guidelines for thyroid stimulating hormone (TSH) level goal for benign (0.5-4.5mIU/L) or malignant (2mIU/L) final pathology. Univariate and multivariate logistic regression analysis was performed.One hundred patients were included and overall 47% required thyroid hormone supplementation after thyroid lobectomy: 73% of those with cancer, 38% with benign pathology (p = 0.002). Patients requiring thyroid hormone supplementation were more likely to have thyroiditis 26% versus 3.8% of those who remained euthyroid (p = 0.002); have a higher preoperative TSH: mean 1.88mIU/L (SD 1.17) versus 1.16mIU/L (SD 0.77) (p = 0.0002), and have a smaller remnant thyroid lobe adjusted for body surface area 2.99ml/m2 versus 3.72ml/m2 (p = 0.003).After thyroid lobectomy, the need for thyroid hormone supplementation is associated with higher preoperative TSH level, thyroiditis, remnant thyroid volume, and malignancy on final pathology. The majority of patients with final pathology of carcinoma will require thyroid hormone supplementation to achieve TSH goal. For patients with benign pathology after thyroid lobectomy the majority will not require thyroid hormone supplementation to achieve TSH goal. |
Databáze: | OpenAIRE |
Externí odkaz: |