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Current Practice of Surgery for Benign Goitre—An Analysis of the Prospective DGAV StuDoQ|Thyroid Registry

Background: To evaluate the current indications, resection strategies and short-term outcomes of surgery for benign goitre in a country with endemic goitre. Methods: Data of patients who underwent surgery for benign goitre were retrieved from the prospective StuDoQ/Thyroid registry and retrospective...

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Autores principales: Bartsch, Detlef K., Dotzenrath, Cornelia, Vorländer, Christian, Zielke, Andreas, Weber, Theresia, Buhr, Heinz J., Klinger, Carsten, Lorenz, Kerstin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6517925/
https://www.ncbi.nlm.nih.gov/pubmed/30965665
http://dx.doi.org/10.3390/jcm8040477
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author Bartsch, Detlef K.
Dotzenrath, Cornelia
Vorländer, Christian
Zielke, Andreas
Weber, Theresia
Buhr, Heinz J.
Klinger, Carsten
Lorenz, Kerstin
author_facet Bartsch, Detlef K.
Dotzenrath, Cornelia
Vorländer, Christian
Zielke, Andreas
Weber, Theresia
Buhr, Heinz J.
Klinger, Carsten
Lorenz, Kerstin
author_sort Bartsch, Detlef K.
collection PubMed
description Background: To evaluate the current indications, resection strategies and short-term outcomes of surgery for benign goitre in a country with endemic goitre. Methods: Data of patients who underwent surgery for benign goitre were retrieved from the prospective StuDoQ/Thyroid registry and retrospectively analysed regarding the patient’s demographics, indications for surgery, surgical procedures, histology, and perioperative outcomes. Results: In a 15-month period, 12,888 patients from 83 departments underwent thyroid resections for benign conditions. Main indications for surgery were exclusion of malignancy (68%), compression symptoms (20.7%) and hyperthyroidism (9.7%). Preoperative fine needle aspiration cytology was performed in only 12.2% of patients with the indication “exclusion of malignancy”. Thyroidectomy (49.8%) or hemithyroidectomy (36.9%) were performed in 86.7% of patients. Minimally invasive or alternative surgical techniques were applied in only 2.2%. Intraoperative neuromonitoring was used in 98.4% of procedures, in 97.5% of patients at least one parathyroid gland was visualized, and in 15.3% of patients parathyroid tissue was autografted, respectively. The rates of unilateral and bilateral transient recurrent nerve palsy were 3.6% and 0.07% of nerves at risk, the rate of transitory hypoparathyroidism was 15.3%. The rates of postoperative bleeding and wound infections requiring reoperation were 1.4% and 0.07%, respectively. Conclusions: The indication “exclusion of malignancy” is made too liberally, and there is a strong attitude to perform complete thyroid resections. Postoperative hypoparathyroidism is the major complication after surgery for benign thyroid disease, thus requiring more awareness.
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spelling pubmed-65179252019-05-31 Current Practice of Surgery for Benign Goitre—An Analysis of the Prospective DGAV StuDoQ|Thyroid Registry Bartsch, Detlef K. Dotzenrath, Cornelia Vorländer, Christian Zielke, Andreas Weber, Theresia Buhr, Heinz J. Klinger, Carsten Lorenz, Kerstin J Clin Med Article Background: To evaluate the current indications, resection strategies and short-term outcomes of surgery for benign goitre in a country with endemic goitre. Methods: Data of patients who underwent surgery for benign goitre were retrieved from the prospective StuDoQ/Thyroid registry and retrospectively analysed regarding the patient’s demographics, indications for surgery, surgical procedures, histology, and perioperative outcomes. Results: In a 15-month period, 12,888 patients from 83 departments underwent thyroid resections for benign conditions. Main indications for surgery were exclusion of malignancy (68%), compression symptoms (20.7%) and hyperthyroidism (9.7%). Preoperative fine needle aspiration cytology was performed in only 12.2% of patients with the indication “exclusion of malignancy”. Thyroidectomy (49.8%) or hemithyroidectomy (36.9%) were performed in 86.7% of patients. Minimally invasive or alternative surgical techniques were applied in only 2.2%. Intraoperative neuromonitoring was used in 98.4% of procedures, in 97.5% of patients at least one parathyroid gland was visualized, and in 15.3% of patients parathyroid tissue was autografted, respectively. The rates of unilateral and bilateral transient recurrent nerve palsy were 3.6% and 0.07% of nerves at risk, the rate of transitory hypoparathyroidism was 15.3%. The rates of postoperative bleeding and wound infections requiring reoperation were 1.4% and 0.07%, respectively. Conclusions: The indication “exclusion of malignancy” is made too liberally, and there is a strong attitude to perform complete thyroid resections. Postoperative hypoparathyroidism is the major complication after surgery for benign thyroid disease, thus requiring more awareness. MDPI 2019-04-08 /pmc/articles/PMC6517925/ /pubmed/30965665 http://dx.doi.org/10.3390/jcm8040477 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bartsch, Detlef K.
Dotzenrath, Cornelia
Vorländer, Christian
Zielke, Andreas
Weber, Theresia
Buhr, Heinz J.
Klinger, Carsten
Lorenz, Kerstin
Current Practice of Surgery for Benign Goitre—An Analysis of the Prospective DGAV StuDoQ|Thyroid Registry
title Current Practice of Surgery for Benign Goitre—An Analysis of the Prospective DGAV StuDoQ|Thyroid Registry
title_full Current Practice of Surgery for Benign Goitre—An Analysis of the Prospective DGAV StuDoQ|Thyroid Registry
title_fullStr Current Practice of Surgery for Benign Goitre—An Analysis of the Prospective DGAV StuDoQ|Thyroid Registry
title_full_unstemmed Current Practice of Surgery for Benign Goitre—An Analysis of the Prospective DGAV StuDoQ|Thyroid Registry
title_short Current Practice of Surgery for Benign Goitre—An Analysis of the Prospective DGAV StuDoQ|Thyroid Registry
title_sort current practice of surgery for benign goitre—an analysis of the prospective dgav studoq|thyroid registry
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6517925/
https://www.ncbi.nlm.nih.gov/pubmed/30965665
http://dx.doi.org/10.3390/jcm8040477
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