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Surgical Indications for Goiter with Background Hashimoto's Thyroiditis: Institutional Experience.
MedLine Citation:
PMID:  23204697     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Hashimoto's thyroiditis (HT) is usually treated conservatively with thyroxine. Its incidence is higher in Iodine sufficient areas and may require surgery for associated nodularity or complications. A retrospective study on surgically treated HT cases was conducted in a teritiary care teaching hospital in an Iodine sufficient area of Southern India. 34 cases of goiter with associated HT, who underwent thyroidectomy between 2007 and 2010 were analysed for indications of surgery. Minimum follow-up period was 6 months. F:M ratio was 31:3 with mean age of 41.3 years. Goiter was diffuse in 41% and nodular in 59%. 16 (47%) of patients were hypothyroid. Autoimmune association was found in 35%. Commonest surgery done was hemithyroidectomy in 12 (35%) followed by subtotal thyroidectomy in 10 cases. Most frequent indication for surgery was nodular goiter in 12 (35%) followed by associated malignancy, persistent goiter, pressure symptoms and painful thyroiditis. Histopathology showed diffuse HT alone in 12 (35%) and rest of the cases had HT as a component synchronous with other pathologies. Associated pathologies were benign multinodular goiter (6), colloid nodule (6), papillary cancer (5), follicular adenoma (4), cyst (1). Surgery for HT is primarily indicated for associated pathologies like dominant nodule, suspicious or proven malignancy, persistent goiter, painful thyroiditis, pressure symptoms and rarely for HT perse. Rate of surgery for HT associated goiter appears to be higher in Iodine sufficient areas, the cause of which needs to be studied further.
Authors:
P R K Bhargav; S Shekhar
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Publication Detail:
Type:  Journal Article     Date:  2011-10-11
Journal Detail:
Title:  The Indian journal of surgery     Volume:  73     ISSN:  0972-2068     ISO Abbreviation:  Indian J Surg     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2012-12-03     Completed Date:  2012-12-04     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  0373026     Medline TA:  Indian J Surg     Country:  India    
Other Details:
Languages:  eng     Pagination:  414-8     Citation Subset:  -    
Affiliation:
Endocrine Surgery Department, Mamata Medical College and Hospital, Khammam, Andhra Pradesh India.
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