Surgical management of thyroid gland swellings in 22 May Hospital, Aden, Yemen

Abstract

Thyroid gland swellings are common clinical presentation of thyroid disorders of various etiologies, to which thyroidectomy is often carried out. The study aimed at analyzing demographic, clinical and pathologic features of patients with thyroid gland swellings, presented to 22 May Hospital and operated during the study period.as well as studying the types of operation used and their complications. This is a retrospective study. All patients who presented to 22 May Hospital from 1st March 2018 to 28th February 2020 and operated were included in the study. Patients with cervical lymphadenopathy, retrosternal goiter, and extrathyroidal tumor invasion were excluded from the study. Relevant data were collected and processed. For statistical analysis, SPSS software vs.17 was used. The Freeman and Halton extension of Fischer exact test was completed using Vassarstat. P-value of ≤0.05 was considered statistically significant. The study included 117 patients. Female preponderance was noted (91.5%). The average age group was 39.4 yrs, with SD ±13.8. Patients had an average duration of complain 50.3 months with SD ± 67.8. Most patients were euthyroid (88.1%) and had no previous thyroid operation (94%). The overall cancer detection rate on histopathology exam was 12% and papillary thyroid cancer was the most frequent histopathologiccancer type (92.8%). Statistically significant difference was found in the cancer detection rate in the different forms of thyroid swellings, the highest rate was found in solitary thyroid nodule (33.3%). Incidental thyroid cancer was found in 2.5% of the research population, but the histopathologic examination of their completed thyroidectomy specimen showed no cancer remnant. The total thyroidectomy was the most frequently practiced thyroidectomy procedure (45.8% of operations). No statistically significant difference was found in the major complications of thyroidectomy procedures of different resection extent. It could be concluded from this study that cancer detection rate in solitary thyroid nodule is significant, therefore, it needs to be carefully identified and investigated thoroughly.