The compensatory enlargement of the remaining thyroid lobe following hemithyroidectomy is small and without impact on symptom relief

Autor: Casper Gronbek, Nina Nguyen, Jesper Roed Sørensen, Christian Godballe, Helle Døssing, Laszlo Hegedüs, Frederik Schultz Pustelnik, Steen Joop Bonnema
Rok vydání: 2017
Předmět:
Male
Goiter
endocrine system diseases
medicine.medical_treatment
Thyroid Gland
Growth
0302 clinical medicine
Surveys and Questionnaires
Postoperative Period
Observer Variation
medicine.diagnostic_test
Thyroid
General Medicine
Organ Size
Middle Aged
Magnetic Resonance Imaging
medicine.anatomical_structure
030220 oncology & carcinogenesis
Thyroidectomy
Female
Neurosurgery
Thyroid function
Thyroid Gland/diagnostic imaging
MRI
Goiter
Nodular
Quality of life
Adult
medicine.medical_specialty
endocrine system
030209 endocrinology & metabolism
03 medical and health sciences
medicine
Journal Article
Humans
Aged
business.industry
Observer agreement
Magnetic resonance imaging
Hypertrophy
medicine.disease
Confidence interval
Surgery
Otorhinolaryngology
Goiter
Nodular/surgery
business
Thyroidectomy/methods
Follow-Up Studies
Zdroj: Pustelnik, F S, Gronbek, C, Døssing, H, Nguyen, N, Bonnema, S J, Hegedüs, L, Godballe, C & Sorensen, J R 2018, ' The compensatory enlargement of the remaining thyroid lobe following hemithyroidectomy is small and without impact on symptom relief ', European Archives of Oto-Rhino-Laryngology, vol. 275, no. 1, pp. 161–167 . https://doi.org/10.1007/s00405-017-4777-3
ISSN: 1434-4726
DOI: 10.1007/s00405-017-4777-3
Popis: According to previous studies, hemithyroidectomy results in growth of the remaining thyroid lobe by up to 30% in first 12 months after surgery. However, this estimate is based on imprecise methods, high inter- and intra-observer variability, and lack of blinding of the measurements. Furthermore, it is unknown whether enlargement of the remaining hemi-thyroid interferes with the improvement in symptoms after surgery for goiter. We aimed to assess the impact of postoperative thyroid growth on goiter symptom relief following hemithyroidectomy in patients with benign nodular goiter. Outcomes were measured before and 6 months after hemithyroidectomy in 44 patients. Thyroid volumes were determined by two independent and blinded observers using magnetic resonance imaging (MRI). Inter- and intra-observer variability was visualized by Bland–Altman plots. Goiter symptoms were assessed by the Thyroid-Specific Patient-Reported-Outcome Questionnaire (ThyPRO) on a scale from 0 to 100 points. After hemithyroidectomy, the remaining thyroid lobe was 13.7 ± 6.4 mL, and enlarged by a mean of 1.8 mL over 6 months [95% confidence interval (CI) (1.6; 2.1), p OpenSPiltSPi 0.001], corresponding to an increase of 17% [95% CI (12; 22)]. The Goiter Symptom score improved by 27 points [95% CI (21; 34), p OpenSPiltSPi 0.0001] from median 39 points (range 2–86) at baseline, and was unaffected by the compensatory thyroid growth. Six months after hemithyroidectomy, using blinded MRI evaluations, we demonstrated a small but significant postoperative growth of the remaining hemi-thyroid, which did not significantly affect the considerable improvement in goiter symptoms.
Databáze: OpenAIRE
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