Indications for the Surgical Management of Benign Goiter in Adults

Bartsch, Detlef K.; Luster, Markus; Buhr, H. J.; Lorenz, D.; Germer, Christoph‐Thomas; Goretzki, P. E.

doi:10.3238/arztebl.2018.0001

Cited by 34 publications

(24 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Neither chronic thyroiditis or primary lymphoma have as first line approach surgery even in selected cases this is indicated (19). Single or multinodular goitre is removed if compressive symptoms are presented; also, in cases with hyperthyroidism (including Basedow-Graves disease regardless the goitre aspect at ultrasound) or in subjects with suspected nodules for a malignancy (20).…”

Section: General Datamentioning

confidence: 99%

Post-thyroidectomy Hypocalcemia - Risk Factors and Management

Păduraru¹,

Ion²,

Cârșote³

et al. 2019

chr

View full text Add to dashboard Cite

show abstract

Section: General Datamentioning

confidence: 99%

Post-thyroidectomy Hypocalcemia - Risk Factors and Management

Păduraru¹,

Ion²,

Cârșote³

et al. 2019

chr

View full text Add to dashboard Cite

show abstract

“…Aktuelle Bestrebungen zur Verbesserung der Ergebnisqualität für die Schilddrüsenchirurgie konzentrieren sich auf die Vermeidung unnötiger Operationen durch eine kritischere Indikationsstellung [16,17], die Schonung des N. recurrens [18][19][20][21] und die Vermeidung bzw. optimierte Versorgung eines postoperativen Hypoparathyreoidismus [22][23][24].…”

Section: Diskussionunclassified

Risikofaktoren für den permanenten postoperativen Hypoparathyreoidismus

et al. 2019

View full text Add to dashboard Cite

Zusammenfassung Hintergrund Der permanente postoperative Hypoparathyreoidismus ist die häufigste Komplikation nach einer totalen Thyreoidektomie mit erheblichen möglichen Folgeerkrankungen, Beeinträchtigung der Lebensqualität und hoher sozioökonomischer Bedeutung. Zielsetzung Identifikation von Risikofaktoren für den permanenten postoperativen Hypoparathyreoidismus. Material und Methoden 420 Patienten unseres Schilddrüsenzentrums erhielten zwischen 08/2012 und 08/2014 eine totale Thyreoidektomie. 382 gingen in die Studie ein. An einer Follow-up-Untersuchung zwischen 8 und 32 Monaten nach der Operation nahmen 117 teil. Ergebnisse Mit einem permanenten postoperativen Hypoparathyreoidismus waren assoziiert: erniedrigter PTH-Wert am 1. postoperativen Tag, Verzicht bzw. Nichterfordernis einer Redon-Drainage und eine lange Krankenhausverweildauer. Die Assoziationen waren ausgeprägt, jedoch nicht signifikant. Diskussion Wir ermittelten Hinweise auf Prädiktoren für den permanenten postoperativen Hypoparathyreoidismus. Eine Validierung als relevante Risikofaktoren sollte in größeren Multicenterstudien erfolgen. Die Kenntnis von Risikofaktoren könnte zur Vermeidung dieser Komplikation und zur gezielten Nachsorgebetreuung gefährdeter Patienten dienen.

show abstract

“…It is often critically noted that, especially in Germany, thyroid resections are indicated too liberally for so-called “cold”, potentially malignant nodules, since the preoperative tools recommended in the guidelines for determining the risk of malignancy are not completely used [2,14]. In the present study, the main indication for surgery was “exclusion of malignancy” in two thirds of patients, but a preoperative FNAC was performed in only 12%, and a preoperative calcitonin screening in only 60% of these patients.…”

Section: Discussionmentioning

confidence: 99%

“…Germany is an endemic goitre area and thyroid resections are among the most frequent visceral operations, with approx. 70,000 procedures being carried out per year [1,2]. Thyroid resections are performed by general surgeons, as well as specialized endocrine surgeons in hospitals of all care levels.…”

Section: Introductionmentioning

confidence: 99%

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

Bartsch

Dotzenrath

Vorländer

et al. 2019

JCM

View full text Add to dashboard Cite

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.

show abstract

Indications for the Surgical Management of Benign Goiter in Adults

Abstract: The decision to operate should be made on an interdisciplinary basis and in conformity with the relevant guidelines after all of the appropriate diagnostic studies have been performed. The radicality of any proposed surgical procedure should be weighed against its potential complications.

Cited by 34 publications

References 45 publications

Post-thyroidectomy Hypocalcemia - Risk Factors and Management

Post-thyroidectomy Hypocalcemia - Risk Factors and Management

Risikofaktoren für den permanenten postoperativen Hypoparathyreoidismus

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

Contact Info

Product

Resources

About