BACKGROUND: A Thyroidectomy Difficulty Scale (TDS) was previously developed that identified more difficult operations, which correlated with longer operative times and higher complication rates. The purpose of this study was to identify preoperative variables predictive of a more difficult thyroidectomy using the TDS. METHODS: A four item, 20-point TDS, was used to score the difficulty of thyroid operations. Patient and disease factors were recorded for each patient. Difficult thyroidectomy and non-difficult thyroidectomy (NDT) patients were compared. A final multivariate logistic regression model was constructed with significant (P<0.05) variables from a univariate analysis. RESULTS: A total of 189 patients were scored using TDS. Of them, 69 (36.5%) suffered from hyperthyroidism, 42 (22.2%) from Hashimotos, 34 (18.0%) from thyroid cancer, and 36 (19.0%) from multinodular goiter. Among hyperthyroid patients, the DT group had a greater number preoperatively treated with Lugols potassium iodide (81.6% DT versus 58.1% NDT, P=0.032), presence of ophthalmopathy (31.6% DT versus 9.7% NDT, P=0.028), and presence of (>4 IU/mL) antithyroglobulin antibodies (34.2% DT versus 12.9% NDT, P=0.05). Using multivariate analysis, hyperthyroidism (odds ratio [OR], 4.35, 95% confidence interval [CI], 1.23-15.36, P=0.02), presence of antithyroglobulin antibody (OR, 3.51, 95% CI, 1.28-9.66, P=0.015), and high (>150 ng/mL) thyroglobulin (OR, 2.61, 95% CI, 1.06-6.42, P=0.037) were independently associated with DT. CONCLUSIONS: Using TDS, we demonstrated that a diagnosis of hyperthyroidism, preoperative elevation of serum thyroglobulin, and antithyroglobulin antibodies are associated with DT. This tool can assist surgeons in counseling patients regarding personalized operative risk and improve OR scheduling.
BACKGROUND: A Thyroidectomy Difficulty Scale (TDS) was previously developed that identified more difficult operations, which correlated with longer operative times and higher complication rates. The purpose of this study was to identify preoperative variables predictive of a more difficult thyroidectomy using the TDS. METHODS: A four item, 20-point TDS, was used to score the difficulty of thyroid operations. Patient and disease factors were recorded for each patient. Difficult thyroidectomy and non-difficult thyroidectomy (NDT) patients were compared. A final multivariate logistic regression model was constructed with significant (P<0.05) variables from a univariate analysis. RESULTS: A total of 189 patients were scored using TDS. Of them, 69 (36.5%) suffered from hyperthyroidism, 42 (22.2%) from Hashimotos, 34 (18.0%) from thyroid cancer, and 36 (19.0%) from multinodular goiter. Among hyperthyroidpatients, the DT group had a greater number preoperatively treated with Lugols potassium iodide (81.6% DT versus 58.1% NDT, P=0.032), presence of ophthalmopathy (31.6% DT versus 9.7% NDT, P=0.028), and presence of (>4 IU/mL) antithyroglobulin antibodies (34.2% DT versus 12.9% NDT, P=0.05). Using multivariate analysis, hyperthyroidism (odds ratio [OR], 4.35, 95% confidence interval [CI], 1.23-15.36, P=0.02), presence of antithyroglobulin antibody (OR, 3.51, 95% CI, 1.28-9.66, P=0.015), and high (>150 ng/mL) thyroglobulin (OR, 2.61, 95% CI, 1.06-6.42, P=0.037) were independently associated with DT. CONCLUSIONS: Using TDS, we demonstrated that a diagnosis of hyperthyroidism, preoperative elevation of serum thyroglobulin, and antithyroglobulin antibodies are associated with DT. This tool can assist surgeons in counseling patients regarding personalized operative risk and improve OR scheduling.
Authors: Louis M Revenig; Daniel J Canter; Maxwell D Taylor; Caroline Tai; John F Sweeney; Juan M Sarmiento; David A Kooby; Shishir K Maithel; Viraj A Master; Kenneth Ogan Journal: J Am Coll Surg Date: 2013-10 Impact factor: 6.113
Authors: Vishnu Sundaresh; Juan P Brito; Zhen Wang; Larry J Prokop; Marius N Stan; Mohammad H Murad; Rebecca S Bahn Journal: J Clin Endocrinol Metab Date: 2013-07-03 Impact factor: 5.958
Authors: David J Terris; Samuel Snyder; Denise Carneiro-Pla; William B Inabnet; Emad Kandil; Lisa Orloff; Maisie Shindo; Ralph P Tufano; R Michael Tuttle; Mark Urken; Michael W Yeh Journal: Thyroid Date: 2013-09-14 Impact factor: 6.568
Authors: A Catania; E Guaitoli; G Carbotta; M Bianchini; F M Di Matteo; S Carbotta; M Nardi; E Fabiani; G Grani; V D'Andrea; A Fumarola Journal: Clin Ter Date: 2013 May-Jun
Authors: F P Prete; P C Panzera; G Di Meo; A Pasculli; L I Sgaramella; G Calculli; R Dimonte; F Ferrarese; M Testini; A Gurrado Journal: Updates Surg Date: 2022-09-05
Authors: Reese W Randle; Maria F Bates; Kristin L Long; Susan C Pitt; David F Schneider; Rebecca S Sippel Journal: Surgery Date: 2017-11-03 Impact factor: 3.982
Authors: Sapana Bothra; Mayilvaganan Sabaretnam; Asish Kannujia; Gyan Chand; Gaurav Agarwal; S K Mishra; Amit Agarwal Journal: Ann Med Surg (Lond) Date: 2019-11-23
Authors: Valerio D'Orazi; Andrea Sacconi; Silvia Trombetta; Menelaos Karpathiotakis; Daniele Pichelli; Enrico Di Lorenzo; Alice Ortensi; Paolo Urciuoli; Marco Biffoni; Andrea Ortensi Journal: BMC Surg Date: 2019-04-24 Impact factor: 2.102