High rate of recurrence after lobectomy for solitary thyroid nodule
| Autor: | Maurizio Marchesi, Marco Biffoni, Fausto Biancari, Cristiana Faloci, Francesco Paolo Campana |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male lobectomy medicine.medical_specialty adenoma hyperplasia recurrence reoperation solitary nodule thyroid Goiter Adenoma Adolescent medicine.medical_treatment Thyroid Function Tests Thyroid function tests Sensitivity and Specificity Severity of Illness Index Cohort Studies Recurrence Biopsy Preoperative Care medicine Humans Minimally Invasive Surgical Procedures Thyroid Nodule Aged Retrospective Studies Solitary pulmonary nodule medicine.diagnostic_test business.industry Incidence Thyroid Biopsy Needle Thyroidectomy Nodule (medicine) Middle Aged medicine.disease Surgery medicine.anatomical_structure Treatment Outcome Female medicine.symptom business Follow-Up Studies Goiter Nodular |
| Zdroj: | The European journal of surgery = Acta chirurgica. 168(7) |
| ISSN: | 1102-4151 |
| Popis: | Objective: To evaluate the long-term outcome of patients treated by lobectomy for solitary thyroid nodule. Design: Retrospective study. Setting: University hospital. Patients: 83 patients admitted with a clinical diagnosis of solitary thyroid nodule. Interventions: Preoperative ultrasonography showed a solitary nodule in 32 patients and thisnding was conrmed intra- operatively in 24 cases (77%). 59 patients with multinodular goitres were treated by total thyroidectomy and 24 with solitary nodule by lobectomy. Main outcome measures: Postoperative complications and freedom from nodule recurrence and/or parenchymal irregularity. Results: One patient after lobectomy and 3 after total thyroidectomy developed temporary recurrent laryngeal nerve injury. Postoperative temporary hypoparathyroidis m occurred in 13 patients (22%) after total thyroidectomy and in no patient after lobectomy (p = 0.02). Neither permanent recurrent laryngeal nerve injury nor permanent hypoparathyroidis m occurred after either procedure. Among patients who underwent lobectomy, 6 had an adenoma and 18 had a nodular hyperplasia. At 4-year follow-up, the freedom rate from any thyroid nodule recurrence or parenchymal irregularity was 44.7%, and the freedom rate from nodular recurrence was 74%. Men tended to have a 4-year freedom rate from nodular relapse poorer than women (48% vs. 87%, p = 0.07). Nodular recurrence occurred in one patient operated on for an adenoma, and all the other recurrences occurred in patients with nodular hyperplasia. Conclusions: The mid-term freedom rate from thyroid nodule recurrence or parenchymal irregularity after lobectomy for solitary nodule of the thyroid is unsatisfactory. This observation calls for a better evaluation of long-term results after lobectomy for this condition and identication of risk factors predictive of recurrence. This would enable a more appropriate preoperative selection of patients undergoing lobectomy, indicating total thyroidectomy for those patients with solitary nodule at high risk of recurrence. |
| Databáze: | OpenAIRE |
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