Kepal N Patel1, Linwah Yip2, Carrie C Lubitz3, Elizabeth G Grubbs4, Barbra S Miller5, Wen Shen6, Peter Angelos7, Herbert Chen8, Gerard M Doherty9, Thomas J Fahey10, Electron Kebebew11, Virginia A Livolsi12, Nancy D Perrier4, Jennifer A Sipos13, Julie A Sosa6, David Steward14, Ralph P Tufano15, Christopher R McHenry16, Sally E Carty2. 1. Division of Endocrine Surgery, NYU Langone Health, New York, NY. 2. Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA. 3. Department of Surgery, Massachusetts General Hospital, Boston, MA. 4. Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX. 5. Division of Endocrine Surgery, University of Michigan, Ann Arbor, MI. 6. Department of Surgery, University of California San Francisco, San Francisco, CA. 7. Department of Surgery and MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL. 8. Department of Surgery, University of Alabama at Birmingham, Birmingham, AL. 9. Department of Surgery, Brigham and Women's Hospital, Boston, MA. 10. Department of Surgery, The New York Presbyterian Hospital-Weill Cornell Medical Center, New York, NY. 11. Department of Surgery and Stanford Cancer Institute, Stanford University, Stanford, CA. 12. Department of Pathology and Laboratory Medicine, Perelman School of Medicine of University of Pennsylvania, Philadelphia, PA. 13. Division of Endocrinology and Metabolism, The Ohio State University, Columbus, OH. 14. Department of Otolaryngology, University of Cincinnati College of Medicine, Cincinnati, OH. 15. Division of Head and Neck Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins School of Medicine, Baltimore, MD. 16. MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH.
Abstract
OBJECTIVE: To develop evidence-based recommendations for safe, effective, and appropriate thyroidectomy. BACKGROUND: Surgical management of thyroid disease has evolved considerably over several decades leading to variability in rendered care. Over 100,000 thyroid operations are performed annually in the US. METHODS: The medical literature from 1/1/1985 to 11/9/2018 was reviewed by a panel of 19 experts in thyroid disorders representing multiple disciplines. The authors used the best available evidence to construct surgical management recommendations. Levels of evidence were determined using the American College of Physicians grading system, and management recommendations were discussed to consensus. Members of the American Association of Endocrine Surgeons reviewed and commented on preliminary drafts of the content. RESULTS: These clinical guidelines analyze the indications for thyroidectomy as well as its definitions, technique, morbidity, and outcomes. Specific topics include Pathogenesis and Epidemiology, Initial Evaluation, Imaging, Fine Needle Aspiration Biopsy Diagnosis, Molecular Testing, Indications, Extent and Outcomes of Surgery, Preoperative Care, Initial Thyroidectomy, Perioperative Tissue Diagnosis, Nodal Dissection, Concurrent Parathyroidectomy, Hyperthyroid Conditions, Goiter, Adjuncts and Approaches to Thyroidectomy, Laryngology, Familial Thyroid Cancer, Postoperative Care and Complications, Cancer Management, and Reoperation. CONCLUSIONS: Evidence-based guidelines were created to assist clinicians in the optimal surgical management of thyroid disease.
OBJECTIVE: To develop evidence-based recommendations for safe, effective, and appropriate thyroidectomy. BACKGROUND: Surgical management of thyroid disease has evolved considerably over several decades leading to variability in rendered care. Over 100,000 thyroid operations are performed annually in the US. METHODS: The medical literature from 1/1/1985 to 11/9/2018 was reviewed by a panel of 19 experts in thyroid disorders representing multiple disciplines. The authors used the best available evidence to construct surgical management recommendations. Levels of evidence were determined using the American College of Physicians grading system, and management recommendations were discussed to consensus. Members of the American Association of Endocrine Surgeons reviewed and commented on preliminary drafts of the content. RESULTS: These clinical guidelines analyze the indications for thyroidectomy as well as its definitions, technique, morbidity, and outcomes. Specific topics include Pathogenesis and Epidemiology, Initial Evaluation, Imaging, Fine Needle Aspiration Biopsy Diagnosis, Molecular Testing, Indications, Extent and Outcomes of Surgery, Preoperative Care, Initial Thyroidectomy, Perioperative Tissue Diagnosis, Nodal Dissection, Concurrent Parathyroidectomy, Hyperthyroid Conditions, Goiter, Adjuncts and Approaches to Thyroidectomy, Laryngology, Familial Thyroid Cancer, Postoperative Care and Complications, Cancer Management, and Reoperation. CONCLUSIONS: Evidence-based guidelines were created to assist clinicians in the optimal surgical management of thyroid disease.
Authors: Paula Soares; Antónia Afonso Póvoa; Miguel Melo; João Vinagre; Valdemar Máximo; Catarina Eloy; José Manuel Cameselle-Teijeiro; Manuel Sobrinho-Simões Journal: Endocr Pathol Date: 2021-03-02 Impact factor: 3.943
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