Document Detail


Postoperative endocrine function in patients with surgically treated thyrotoxicosis.
MedLine Citation:
PMID:  15054736     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Endocrine function after surgery for thyrotoxicosis is difficult to predict. The operative morbidity and long-term thyroid function of patients surgically treated for thyrotoxicosis is presented, and factors postulated to affect long-term function are correlated with outcome. METHODS: The clinical records of 289 consecutive patients who underwent surgery for thyrotoxicosis were reviewed. Indications for surgery, intraoperative findings, postoperative complications, and endocrine status 1, 2, and 5 years after surgery were analyzed. Sex, age, duration of medical treatment, weight of thyroid removed and preserved, and antimicrosomal/antithyroglobulin antibody status were correlated with outcome 5 years after surgery. RESULTS: The incidence of permanent recurrent laryngeal nerve injury and hypocalcemia were 0.7% and 1.7%. The cumulative hypothyroid and hyperthyroid rates for the first, second, and fifth postoperative years were 13.8% and 3.5%, 14.5% and 4.8%, and 15.6% and 8.0%. All the prognostic variables analyzed did not achieve a significant correlation with outcome at 5 years by univariate and multivariate age- and sex-adjusted relative risk. CONCLUSIONS: Failure from hypothyroidism develops early; recurrent hyperthyroidism increases with the number of years of follow-up. Patients undergoing subtotal thyroidectomy warrant long-term follow-up because of the inability to accurately predict postoperative function with consistently reliable prognostic factors.
Authors:
Ranjiv Sivanandan; Lay Guat Ng; Lay Wai Khin; Teck Hock Dennis Lim; Khee Chee Soo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Head & neck     Volume:  26     ISSN:  1043-3074     ISO Abbreviation:  Head Neck     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-03-31     Completed Date:  2004-07-29     Revised Date:  2006-10-05    
Medline Journal Info:
Nlm Unique ID:  8902541     Medline TA:  Head Neck     Country:  United States    
Other Details:
Languages:  eng     Pagination:  331-7     Citation Subset:  IM    
Copyright Information:
Copyright 2004 Wiley Periodicals, Inc.
Affiliation:
Department of Surgery, Singapore General Hospital, Singapore. ranjiv@ohns.stanford.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Goiter / diagnosis
Graves Disease / diagnosis
Humans
Hyperthyroidism / etiology*
Hypocalcemia / etiology*
Hypothyroidism / etiology*
Laryngeal Nerves / injuries
Male
Multivariate Analysis
Organ Size
Postoperative Complications*
Prognosis
Recurrence
Thyroid Gland / pathology
Thyroidectomy / methods
Thyrotoxicosis / surgery*
Time Factors
Treatment Outcome
Comments/Corrections
Comment In:
Head Neck. 2005 Nov;27(11):1014; author reply 1014-5   [PMID:  16136582 ]

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