Camille Marciniak1, Xavier Lenne, Guillaume Clément, Amélie Bruandet, Jean-Christophe Lifante, Frédéric Sebag, Eric Mirallié, Muriel Mathonnet, Laurent Brunaud, Gianluca Donatini, Christophe Tresallet, Fabrice Ménégaux, Didier Theis, François Pattou, Robert Caiazzo. 1. General and Endocrine Surgery Department, Lille University Hospital CHU Lille, Lille, France.; Inserm, U1190 Recherche translationnelle sur le diabète (EGID), Lille University UniversityLille, Lille, France Medical Information Department, Lille University Hospital, Lille, France University of Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France CHU Lyon Sud, Department of General and Endocrine Surgery, Lyon APHM Hôpital La Conception, Department of Endocrine Surgery, Marseille CHU Nantes, Department of General and Endocrine Surgery, Nantes CHU Limoges, Department of General and Endocrine Surgery, Limoges CHRU Nancy, Department of General and Endocrine Surgery, Nancy Department of General and Endocrine Surgery, CHU Poitiers; Inserm U1082 - IRTOMIT Ischémie Reperfusion en Transplantation d'Organes Mécanismes et Innovations Thérapeutiques APHP - Avicenne, Department of General and Endocrine Surgery, Paris APHP Pitié - Salpétrière, Department of General and Endocrine Surgery, Paris.
Abstract
National and international guidelines about thyroid surgery seem to be moving more and more towards less radical surgical procedures but everyday practice does not seem to always align with them. We describe for the first time the role of non-surgical parameters in the surgeon's choice for thyroid surgery. OBJECTIVE: To describe thyroid surgery and to identify the factors leading to either a total or a partial thyroidectomy regardless of the severity of the thyroid disease. SUMMARY BACKGROUND DATA: National and international guidelines about thyroid surgery seem to be moving more and more towards less radical surgical procedures but everyday practice does not seem to always align with them. METHODS: We based this nationwide retrospective cohort study on a national database that compiles discharge abstracts for every admission for thyroidectomy to French acute healthcare facilities (PMSI database 2010 to 2019). RESULTS: In this study, 375,810 patients (male: 23%; age = 53 ± 15 y) had a thyroidectomy (partial: 28%) for cancer (17%), hyperthyroidism (16%), non-functioning goiter (64%) or other (3%). We noticed a global trend toward more partial thyroidectomy (p < 0.001) with a significant increase in the proportion of lobectomy in the post-ATA recommendations' period (p < 0.001) as well as in the "French Levothyrox crisis" period, in which we saw an unexpected rise of adverse events notifications associated with the marketing of a new formula of Levothyrox (p < 0.001) amid widespread media coverage. In a multivariate analysis, we also identified that complete resection was more frequently performed in centers with a caseload > 40/y (p < 0.001, OR = 1.48), for obese patients (BMI> 30 kg/m2; p < 0.001, OR = 1.42), and according to the indication of surgery (OR benign = 1, OR cancer = 2.25, OR hyperthyroidism = 4.13). CONCLUSION: We describe for the first time the role of non-surgical parameters in the surgeon's choice for thyroid surgery.
National and international guidelines about thyroid surgery seem to be moving more and more towards less radical surgical procedures but everyday practice does not seem to always align with them. We describe for the first time the role of non-surgical parameters in the surgeon's choice for thyroid surgery. OBJECTIVE: To describe thyroid surgery and to identify the factors leading to either a total or a partial thyroidectomy regardless of the severity of the thyroid disease. SUMMARY BACKGROUND DATA: National and international guidelines about thyroid surgery seem to be moving more and more towards less radical surgical procedures but everyday practice does not seem to always align with them. METHODS: We based this nationwide retrospective cohort study on a national database that compiles discharge abstracts for every admission for thyroidectomy to French acute healthcare facilities (PMSI database 2010 to 2019). RESULTS: In this study, 375,810 patients (male: 23%; age = 53 ± 15 y) had a thyroidectomy (partial: 28%) for cancer (17%), hyperthyroidism (16%), non-functioning goiter (64%) or other (3%). We noticed a global trend toward more partial thyroidectomy (p < 0.001) with a significant increase in the proportion of lobectomy in the post-ATA recommendations' period (p < 0.001) as well as in the "French Levothyrox crisis" period, in which we saw an unexpected rise of adverse events notifications associated with the marketing of a new formula of Levothyrox (p < 0.001) amid widespread media coverage. In a multivariate analysis, we also identified that complete resection was more frequently performed in centers with a caseload > 40/y (p < 0.001, OR = 1.48), for obesepatients (BMI> 30 kg/m2; p < 0.001, OR = 1.42), and according to the indication of surgery (OR benign = 1, OR cancer = 2.25, OR hyperthyroidism = 4.13). CONCLUSION: We describe for the first time the role of non-surgical parameters in the surgeon's choice for thyroid surgery.
Authors: Whitney Sutton; Philip K Crepeau; Joseph K Canner; Shkala Karzai; Dorry L Segev; Aarti Mathur Journal: Am J Surg Date: 2022-02-01 Impact factor: 3.125
Authors: Elisa Pasqual; Julie Ann Sosa; Yingxi Chen; Sara J Schonfeld; Amy Berrington de González; Cari M Kitahara Journal: Thyroid Date: 2022-03-15 Impact factor: 6.506