Nontoxic Multinodular Goitre and Incidental Thyroid Cancer: What Is the Best Surgical Strategy?—A Retrospective Study of 2032 Patients
Objectives. A discussion with regard to the most optimal surgical procedure in nontoxic multinodular goitre (NTMNG). We assessed and compared three main types of operations in 2032 patients with NTMNG. Methods. This is a retrospective study of 2032 patients operated on in one center due to NTMNG. Th...
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Wiley
2018-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2018/4735436 |
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| author | Krzysztof Kaliszewski Beata Wojtczak Jędrzej Grzegrzółka Jacob Bronowicki Sawsan Saeid Bartłomiej Knychalski Zdzisław Forkasiewicz |
| author_facet | Krzysztof Kaliszewski Beata Wojtczak Jędrzej Grzegrzółka Jacob Bronowicki Sawsan Saeid Bartłomiej Knychalski Zdzisław Forkasiewicz |
| author_sort | Krzysztof Kaliszewski |
| collection | DOAJ |
| description | Objectives. A discussion with regard to the most optimal surgical procedure in nontoxic multinodular goitre (NTMNG). We assessed and compared three main types of operations in 2032 patients with NTMNG. Methods. This is a retrospective study of 2032 patients operated on in one center due to NTMNG. The observation period was 48 to 120 months (mean and SD: 87 ± 20). Results. The early complications included uni- and bilateral recurrent laryngeal nerve paralysis (URLNP, BRLNP), overt tetany (OT), and postoperative bleeding (POB). We observed after TT, STT, and DO URLNP: 15 (1.73%), 3 (0.64%), and 2 (0.28%), respectively (p<0.05); BRLNP: 3 (0.34%), 2 (0.43%), and 0 (0.0%), respectively (p=0.25); OT: 42 (4.84%), 6 (1.29%), and 9 (1.28%), respectively (p<0.0001); and POB: 11 (1.26%), 4 (0.86%), and 3 (0.42%), respectively (p=0.209). Persistent complications we observed after TT, STT, and DO are the following: URLNP: 9 (1.03%), 3 (0.64%), and 1 (0.14%), respectively (p=0.086); BRLNP: 1 (0.11%), 1 (0.21%), and 0 (0.0%), respectively (p=0.51); and OT: 11 (1.26%), 2 (0.43%), and 2 (0.28%), respectively (p=0.052). Incidental thyroid cancer (ITC) was recognized after TT, STT, and DO in 18 (2.07%), 21 (4.52%), and 11 (1.56%), respectively (p=0.039). Recurrent goitre (RG) was observed in 1 (0.11%) after TT, 3 (0.64%) after STT, and 2 (0.28%) after DO (p=0.234). Conclusions. Performing less radical surgery in NTMNG is associated with a significantly lower risk of early and late URLNP and OT. In the case of BRLNP (early and persistent) and POB, no statistically significant differences are seen. The occurrence of ITC is higher following more radical surgeries. Less radical surgery is connected with a higher risk of RG. |
| format | Article |
| id | doaj-art-5fa0ae7913bc4250bf109ed8eae87b0b |
| institution | Kabale University |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2018-01-01 |
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| series | International Journal of Endocrinology |
| spelling | doaj-art-5fa0ae7913bc4250bf109ed8eae87b0b2025-08-20T03:34:53ZengWileyInternational Journal of Endocrinology1687-83371687-83452018-01-01201810.1155/2018/47354364735436Nontoxic Multinodular Goitre and Incidental Thyroid Cancer: What Is the Best Surgical Strategy?—A Retrospective Study of 2032 PatientsKrzysztof Kaliszewski0Beata Wojtczak1Jędrzej Grzegrzółka2Jacob Bronowicki3Sawsan Saeid4Bartłomiej Knychalski5Zdzisław Forkasiewicz6First Department and Clinic of General, Gastroenterological and Endocrine Surgery, Wroclaw Medical University, Maria Sklodowska-Curie Street 66, 50-369 Wroclaw, PolandFirst Department and Clinic of General, Gastroenterological and Endocrine Surgery, Wroclaw Medical University, Maria Sklodowska-Curie Street 66, 50-369 Wroclaw, PolandDepartment of Human Morphology and Embryology, Division of Histology and Embryology, Medical University, Chalubinskiego Street 6a, 50-368 Wroclaw, PolandStudents’ Scientific Club of the First Department and Clinic of General, Gastroenterological and Endocrine Surgery, Wroclaw Medical University, Wroclaw, PolandStudents’ Scientific Club of the First Department and Clinic of General, Gastroenterological and Endocrine Surgery, Wroclaw Medical University, Wroclaw, PolandFirst Department and Clinic of General, Gastroenterological and Endocrine Surgery, Wroclaw Medical University, Maria Sklodowska-Curie Street 66, 50-369 Wroclaw, PolandFirst Department and Clinic of General, Gastroenterological and Endocrine Surgery, Wroclaw Medical University, Maria Sklodowska-Curie Street 66, 50-369 Wroclaw, PolandObjectives. A discussion with regard to the most optimal surgical procedure in nontoxic multinodular goitre (NTMNG). We assessed and compared three main types of operations in 2032 patients with NTMNG. Methods. This is a retrospective study of 2032 patients operated on in one center due to NTMNG. The observation period was 48 to 120 months (mean and SD: 87 ± 20). Results. The early complications included uni- and bilateral recurrent laryngeal nerve paralysis (URLNP, BRLNP), overt tetany (OT), and postoperative bleeding (POB). We observed after TT, STT, and DO URLNP: 15 (1.73%), 3 (0.64%), and 2 (0.28%), respectively (p<0.05); BRLNP: 3 (0.34%), 2 (0.43%), and 0 (0.0%), respectively (p=0.25); OT: 42 (4.84%), 6 (1.29%), and 9 (1.28%), respectively (p<0.0001); and POB: 11 (1.26%), 4 (0.86%), and 3 (0.42%), respectively (p=0.209). Persistent complications we observed after TT, STT, and DO are the following: URLNP: 9 (1.03%), 3 (0.64%), and 1 (0.14%), respectively (p=0.086); BRLNP: 1 (0.11%), 1 (0.21%), and 0 (0.0%), respectively (p=0.51); and OT: 11 (1.26%), 2 (0.43%), and 2 (0.28%), respectively (p=0.052). Incidental thyroid cancer (ITC) was recognized after TT, STT, and DO in 18 (2.07%), 21 (4.52%), and 11 (1.56%), respectively (p=0.039). Recurrent goitre (RG) was observed in 1 (0.11%) after TT, 3 (0.64%) after STT, and 2 (0.28%) after DO (p=0.234). Conclusions. Performing less radical surgery in NTMNG is associated with a significantly lower risk of early and late URLNP and OT. In the case of BRLNP (early and persistent) and POB, no statistically significant differences are seen. The occurrence of ITC is higher following more radical surgeries. Less radical surgery is connected with a higher risk of RG.http://dx.doi.org/10.1155/2018/4735436 |
| spellingShingle | Krzysztof Kaliszewski Beata Wojtczak Jędrzej Grzegrzółka Jacob Bronowicki Sawsan Saeid Bartłomiej Knychalski Zdzisław Forkasiewicz Nontoxic Multinodular Goitre and Incidental Thyroid Cancer: What Is the Best Surgical Strategy?—A Retrospective Study of 2032 Patients International Journal of Endocrinology |
| title | Nontoxic Multinodular Goitre and Incidental Thyroid Cancer: What Is the Best Surgical Strategy?—A Retrospective Study of 2032 Patients |
| title_full | Nontoxic Multinodular Goitre and Incidental Thyroid Cancer: What Is the Best Surgical Strategy?—A Retrospective Study of 2032 Patients |
| title_fullStr | Nontoxic Multinodular Goitre and Incidental Thyroid Cancer: What Is the Best Surgical Strategy?—A Retrospective Study of 2032 Patients |
| title_full_unstemmed | Nontoxic Multinodular Goitre and Incidental Thyroid Cancer: What Is the Best Surgical Strategy?—A Retrospective Study of 2032 Patients |
| title_short | Nontoxic Multinodular Goitre and Incidental Thyroid Cancer: What Is the Best Surgical Strategy?—A Retrospective Study of 2032 Patients |
| title_sort | nontoxic multinodular goitre and incidental thyroid cancer what is the best surgical strategy a retrospective study of 2032 patients |
| url | http://dx.doi.org/10.1155/2018/4735436 |
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