Thyroidectomy for Hashimoto's Thyroiditis: Complications and Associated Cancers

Shih, Ming-Lang; Lee, James A.; Hsieh, Chung-Bao; Yu, Jyh-Cherng; Liu, Hsaio-Dung; Kebebew, Electron; Clark, Orlo H.; Duh, Quan‐Yang

doi:10.1089/thy.2007.0384

Cited by 109 publications

(105 citation statements)

References 13 publications

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“…These include thyroidectomy for Graves' disease, Hashimoto's thyroiditis, large goitre, or widely invasive thyroid carcinomas. 6,[9][10][11][12] For example, transient complications range from 12 -38% for patients with Hashimoto's thyroiditis and 11-28% for Graves' disease. 6,11,13 Permanent complications are also reported to be higher in these subsets.…”

Section: During the Late 19mentioning

confidence: 99%

Predicting difficulty of thyroidectomy preoperatively

Oommen

Remin

2017

Int Surg J

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Background: Today, thyroidectomy is a common operation used to treat various thyroid disorders. Nowadays, many high-volume thyroid surgeons are discharging patients on the same day of thyroidectomy. The incidence of complications following thyroidectomy is directly linked to the difficulty of the procedure. So, if we can predict the difficulty of thyroidectomy preoperatively, we can anticipate complications and decide on which patients will require in-patient care.Methods: A thyroidectomy difficulty scale was developed by Schneider and colleagues. This scale was used in our study to classify patients in to difficult thyroidectomy group and non-difficult thyroidectomy group. The association between preoperative variables and difficulty of thyroidectomy was studied.Results: Statistical analysis revealed that there was a significant association between hyperthyroidism and difficult thyroidectomy. Similarly, there was a significant association between positive anti-thyroid peroxidase antibody (which defines Hashimoto’s thyroiditis) and difficult thyroidectomy. Also, there was a significant association between positive anti-thyroglobulin antibody and difficult thyroidectomy. Difficult thyroidectomy was found to have a significant association with postoperative hypocalcemia. Statistical analysis also showed duration of surgery to have a significant association with difficulty of thyroidectomyConclusions: Patients with hyperthyroidism, positive anti-thyroid peroxidase antibodies, positive anti-thyroglobulin antibodies have a high probability of a difficult thyroidectomy, associated with longer operative times and increased complications. This information can improve preoperative risk counseling and lead to more efficient scheduling of the operating room.

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Section: During the Late 19mentioning

confidence: 99%

Predicting difficulty of thyroidectomy preoperatively

Oommen

Remin

2017

Int Surg J

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“…18 This may be due to the role of autoimmunity as suggested by the increased occurrence of postoperative hypocalcemia with other autoimmune thyroid disorders like Hashimoto thyroiditis. 25 Surgical techniques employed during the procedure may also have implications for the risk of postoperative hypocalcemia. The ligation of the inferior thyroid artery (ITA) is associated with a greater risk of hypocalcemia as compared with ligation of the tertiary branches.…”

Section: Risk Factorsmentioning

confidence: 99%

Hypocalcemia: What a Surgeon should know

Mayilvaganan¹,

Kolly²,

Sarathi³

et al. 2017

World Journal of Endocrine Surgery

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Hypocalcemia is one of the sequelae following thyroidectomy (TT) and becomes a complication when it becomes permanent. Parathyroid preservation is a crucial step in the skillful operative procedure of TT. When due care is not taken, the surgeon and the treating physician are faced with the issue of treating the dreaded complication of permanent hypocalcemia. In this article, we address the issue of hypocalcemia following thyroid surgery and its management.

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“…37 The treatment of children and adolescents with subclinical hypothyroidism (normal fT4, high TSH) is controversial. The long-term follow-up studies of children with subclinical hypothyroidism due to AIT suggested a significant likelihood of remission.…”

Section: Diagnosismentioning

confidence: 99%

Hashimoto’s Thyroiditis in Adolescents

Santos¹,

Fonseca²,

Cardoso³

et al. 2015

US Endocrinology

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The autoimmune thyroid diseases (AITD) comprise a series of interrelated conditions including Graves' disease (GD) and Hashimoto's thyroiditis (HT). AITD are the most prevalent diseases of the thyroid gland in the pediatric population, particularly in adolescence. 1HT is the leading cause of goiter and hypothyroidism in children and adolescents in countries with adequate iodine supplementation. [2][3] In an American population aged between 11 and 18 years, five new cases were detected out of 1,000 adolescents screened every year. 4 It is a much more common condition in females than in males: 4:1 to 8:1 depending on the geographic region. [4][5][6] In the last decade, discoveries in molecular biology field have allowed new insight into the genes involved in the development of AITD. At least six susceptibility genes whose variants have been associated with AITD were identified: HLA-DR, CD40, CTLA-4, PTPN22, thyroglobulin (Tg), and thyroid stimulating hormone (TSH) receptor. 7 Genetic susceptibility accounts for 70 % risk for disease that, once combined with environmental factors, play a crucial role in the initiation and progression of the disease. 8 Studies with immunoglobulin (Ig)-G4 autoantibody levels in juvenile thyroid disease patients showed evidence of heritability.9 EtiologyHT etiology is multifactorial. The susceptibility to the disease is determined by an interaction between genetic, environmental, and endogenous factors. 10,11 Genetic susceptibility is well evidenced by studies of monozygotic and dizygotic twins where the concordance rate for HT is around 38 % for monozygotic and 0 % for dizygotic twins. 12 Although genetic factors play a crucial role in the development of HT, nongenetic factors (environmental) are also involved. In immigrant populations from countries with a low incidence of diseases, this population adopts the new country's incidence rate. 13Strong evidence suggests iodine as the most significant environmental factor in the generation of thyroiditis. In fact, the prevalence of AITD increase in certain geographical regions, such as Japan and the US, and correlates with iodine intake. 14 The concentration of iodine in the thyroid AbstractHashimoto's thyroiditis (HT) is the most common cause of hypothyroidism in adolescence and mainly affects females. Being the archetype of an organ-specific T-cell-mediated disease, it is characterized by lymphocytic infiltration of the thyroid gland, damage to the thyroid follicular cells, and impaired ability to produce thyroid hormones. It may be associated with other autoimmune diseases and may arise in the context of congenital chromosomal aberrations. Symptoms of hypothyroidism develop insidiously. In adolescents the most common manifestation is the increase of the glandular volume. Hypothyroidism manifestations (asthenia, intolerance to cold, constipation, and/or skin and dry hair) are less common. The diagnosis is based on the presence of thyroid antibodies and characteristic imaging abnormalities on thyroid ultrasound. The treatment relies on t...

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Thyroidectomy for Hashimoto's Thyroiditis: Complications and Associated Cancers

Abstract: Thyroidectomy can be performed in patients with Hashimoto's thyroiditis with a low risk of permanent surgical complications. Cancer is common in patients who have a thyroidectomy for Hashimoto's thyroiditis even when not suspected preoperatively.

Cited by 109 publications

References 13 publications

Predicting difficulty of thyroidectomy preoperatively

Predicting difficulty of thyroidectomy preoperatively

Hypocalcemia: What a Surgeon should know

Hashimoto’s Thyroiditis in Adolescents

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