The prevalence of post-thyroidectomy chronic asthenia: a prospective cohort study

Abstract

Purpose Chronic asthenia (CA) is complained by some patients that have undergone thyroid surgery. We evaluate its impact in patients undergoing unilateral or bilateral thyroidectomy, the trend during a 1-year follow-up, and the possible risk factors. Methods A prospective, cohort study was carried out on 263 patients scheduled for thyroidectomy from 2012 and 2014. Exclusion criteria were as follows: Graves' disease, malignancies requiring radioiodine therapy, post-surgical hypoparathyroidism, laryngeal nerve palsy, abnormal pre-and postoperative thyroid hormone levels, and BMI outside the normal range. Demographics; smoking and alcoholism addiction; cardiac, pulmonary, renal, and hepatic failure; diabetes; anxiety; and depression were recorded. The Brief Fatigue Inventory (BFI) was used to evaluate CA and its possible association with these comorbidities 6 and 12 months after thyroidectomy. Results One hundred seventy-seven patients underwent total thyroidectomy (TT), 54 hemithyroidectomy (HT). Thirty-two patients were not recorded because of the onset of exclusion criteria. In the 6 months after thyroidectomy, in the TT group, 64 patients (36.16%) reported an impairment in the BFI score and only 1 in the TL group. The mean BFI score changed from 1.663(±1.191) to 2.16 (±11.148) in the TT group, from 1.584 (±1.371) to 1.171 (±1.093) in the TL group (p < 0.001). No further significant variations in BFI were reported 1 year after surgery. Conclusions CA worsened after TT, but not after HT. Apart from operative procedure itself, no other risk factor was found be significantly associated with post-thyroidectomy asthenia. Further investigation is needed to determine the causes of CA.

Surgical Approach to Primary Hyperparathyroidism in Patients with Concomitant Thyroid Diseases: A Retrospective Single Center Study

“…Although the majority of concurrent thyroid disease resulted was benign, a not negligible prevalence of incidentally discovered thyroid malignancy was previously reported. In particular, papillary microcarcinoma was disclosed in 12% of the series of 103 patients reported by Bentrem et al [12], 17.6% among the 51 patients reported by Kösem et al [19], 13% among the 85 patients reported by Latina et al [10], and 32.2% of the 231 patients belonging to a series by Scerrino et al [15].…”

“…Finally, the surgical approach to PHPT may be changed if thyroid disease is also present [9,15,16]. While the simultaneous TX and PTX are mandatory in case of malignancy suspicion, the surgical approach in case of concomitant thyroid disease unsuspected for malignancy is still debated [9,15,16]. Italian AME guidelines [17] in 2012 suggested to treat nodular thyroid disease concomitantly to PHPT, in order to avoid repetitive surgery that would be more worrisome owing to postsurgical adhesions.…”

“…Few surgical series [12,15,19] of PHPT patients with concomitant thyroid disease reported an extensive use of simultaneous surgery, with BNE more frequently performed in comparison to patients without thyroid disease. Although the majority of concurrent thyroid disease resulted was benign, a not negligible prevalence of incidentally discovered thyroid malignancy was previously reported.…”

Non-functioning parathyroid cystic tumour: malignant or not? Report of a case

“…Long-term follow-up and information on mortality are not available, but the advanced stage of the PC at diagnosis likely predict a poor prognosis, worse than that of patients with classical hypercalcemic PC (2,7,9,(49)(50)(51)(52)(53). In the present case, we preferred to perform a thyroid lobectomy because of the pre-existent ipsi-lateral vocal fold paralysis and for taking the opportunity of avoiding the possible sequelae and complications of the total thyroidectomy (57)(58)(59)). An emostatic agent (gelatin-thrombin matrix) was used with the aim of preventing postoperative emorrhage (60,61).…”

23-hour observation endocrine neck surgery: lessons learned from a case series of over 1700 patients

“…These conclusions were confirmed in a 2011 BAETS consensus statement (53). In our opinion, a complete patient's information and the consequent informed consent is mandatory (54,55) for achieving the best results, especially in terms of patient's satisfaction.…”