A. Asban1, A. Anue1, H. Chen1 1University Of Alabama at Birmingham,Department Of Surgery,Birmingham, Alabama, USA
Introduction:
Thyroidectomy is a definitive treatment for hyperthyroidism. The initial discussion to undergo thyroidectomy is usually carried out between a patient and a primary care physician or an endocrinologist. At our institution, it is unknown how often patients with hyperthyroidism are referred for thyroidectomy and what are the common reasons for referral. Therefore, the purpose of this study is to examine the trend of thyroidectomy over a 6-year period and to identify reasons for referral.
Methods:
We identified 237 patients with hyperthyroidism underwent thyroidectomy from January 2016 to December 2016. To examine the trend of thyroidectomy over the study period, patients were divided into six groups according to the year of thyroidectomy, group 1 to group 6, from 2011 to 2016, respectively. For each group, patients’ charts were reviewed for the reasons why patient was referred for thyroidectomy (primary outcome), time from diagnosis and/or start of antithyroid drugs (ATDs) to thyroidectomy, as well as the trend and total number of thyroidectomies each surgeon did during the study period (secondary outcomes). Differences in primary and secondary outcomes between groups were examined.
Results:
The mean age was 44 ± 15 years, 73% were women, and 54% were Caucasian. Majority of patients presented with palpitation 65%, weight loss 50% and heat intolerance 44%. The median preoperative TSH was 0.008 mU/L. A significant increase in the rate of thyroidectomy over the study period was observed where 31 patients underwent thyroidectomy in 2011 compared to 61 patients in 2016. Among the total cohort, the most common reasons patients were referred for thyroidectomy were resistance or intolerance to ATDs followed by patient’s preference and presentation with obstructive symptoms with no statistically significant difference between groups. The median time from diagnosis to surgery was 8 months (0 to 204 months) and 7 months from initiation of ATDs to thyroidectomy with no significant difference between groups. A total of 13 surgeons operated in during the study period with no noticeable change in volume over time.
Conclusion:
An increase of thyroidectomy rate was observed at our institution over the last 6 years. Patients mostly referred due to resistance or intolerance to antithyroid medications, patients’ preference of surgery and presentation with obstructive symptoms. ?