Hee Yong Kwak1, Gianlorenzo Dionigi2, Xiaoli Liu3, Hui Sun3, Sang Uk Woo1, Gil Soo Son1, Jae Bok Lee1, Jeoung Won Bae1, Hoon Yub Kim4. 1. Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea. 2. 1st Division of Surgery, Department of Surgical Sciences, Endocrine Surgery Research Center, University of Insubria, Varese, Italy. 3. Jilin Provincial Key Laboratory of Surgical Translational Medicine, Japan Union Hospital of Jilin University, Division of Thyroid Surgery, Changchun City, Jilin Province, China. 4. Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea. Electronic address: hoonyubkim@gmail.com.
Abstract
BACKGROUND/ OBJECTIVE: Conventional open thyroidectomy is considered as a safe surgery nowadays. However, surgeons sometimes encounter unexpected difficulty when performing thyroidectomies. The aim of this paper was to identify the predictors of a difficult thyroidectomy for the management of patients with papillary thyroid carcinoma. METHODS: A database of patients who underwent open conventional thyroidectomy with cervical lymph node dissection after diagnosed papillary thyroid carcinoma between July 2008 and June 2013 was examined. In addition, the patients were subgrouped by difficult thyroidectomy (DT) and nondifficult thyroidectomy to determine the predictors of DT according to operation time. Clinicopathologic characteristics, surgical outcomes, and postoperative morbidities were investigated. RESULTS: No between-group differences in clinicopathologic factors and postoperative complications, except for male sex (p < 0.001) and tumor size (p = 0.039), were noted. Male sex [odds ratio (OR) 4.158, 95% confidence interval (CI) 2.020-8.559, p = 0.043] and age < 45 years (OR 2.239, 95% CI 1.304-3.843, p = 0.003) were independent factors associated with DT in a multivariate logistic regression model. Elevated antithyroglobulin antibody (OR 1.004, 95% CI 1.000-1.008, p = 0.030) was a variable which is statistically significant, but not clinically significant. DISCUSSION: Young age and male sex might be regarded as predictors of DT. Expecting DT before surgery might help surgeons, especially beginners, prevent troublesome situations.
BACKGROUND/ OBJECTIVE: Conventional open thyroidectomy is considered as a safe surgery nowadays. However, surgeons sometimes encounter unexpected difficulty when performing thyroidectomies. The aim of this paper was to identify the predictors of a difficult thyroidectomy for the management of patients with papillary thyroid carcinoma. METHODS: A database of patients who underwent open conventional thyroidectomy with cervical lymph node dissection after diagnosed papillary thyroid carcinoma between July 2008 and June 2013 was examined. In addition, the patients were subgrouped by difficult thyroidectomy (DT) and nondifficult thyroidectomy to determine the predictors of DT according to operation time. Clinicopathologic characteristics, surgical outcomes, and postoperative morbidities were investigated. RESULTS: No between-group differences in clinicopathologic factors and postoperative complications, except for male sex (p < 0.001) and tumor size (p = 0.039), were noted. Male sex [odds ratio (OR) 4.158, 95% confidence interval (CI) 2.020-8.559, p = 0.043] and age < 45 years (OR 2.239, 95% CI 1.304-3.843, p = 0.003) were independent factors associated with DT in a multivariate logistic regression model. Elevated antithyroglobulin antibody (OR 1.004, 95% CI 1.000-1.008, p = 0.030) was a variable which is statistically significant, but not clinically significant. DISCUSSION: Young age and male sex might be regarded as predictors of DT. Expecting DT before surgery might help surgeons, especially beginners, prevent troublesome situations.
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: 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