No abstract

Thyroid cancers are quite rare, accounting for only 1.5% of all cancers in adults and 3% of all cancers in children. Differentiated thyroid cancer comprises 95% of all thyroid cancers. Of all thyroid cancers 74-80% of cases are papillary cancers. Incidences of follicular carcinoma are higher in regions where incidence of endemic goiter is high. Surgery is the definitive management of thyroid cancer. There is agreement that patients with large, locally aggressive or metastatic differentiated thyroid cancer require total thyroidectomy but there is continuing disagreement on the most appropriate operation for 'low risk' differentiated thyroid cancer. Adjuvant treatments are thyroid hormone suppression and radioiodine therapy rather than chemotherapy and radiotherapy. Prognosis is generally excellent and is influenced by factors related to the patient, the disease and the therapy. This article reviews the basis of surgical treatment of differentiated thyroid cancer and assesses the evidences supporting the surgical options. Key words: Papillary Carcinoma; Follicular Carcinoma; Hemithyroidectomy; Total Thyroidectomy DOI: 10.3329/bjo.v16i2.6848Bangladesh J Otorhinolaryngol 2010; 16(2): 126-130

Abstract

Objective: Although it was reported that cholecystectomy had complex impact on lipid profile in cholelithiasis, lipoprotein (a) [Lp(a)] was not studied. The present study was therefore conducted on serum Lp(a) status in Bangladeshi patients with cholelithiasis and effect of cholecystectomy on it. Patients and Methods: Adult patients (n=44) with cholelithiasis and 30 normal controls (NC) were included in the study. The blood sample was taken from fasting patients before cholecystectomy (Serum-I 0), gall bladder bile sample during cholecystectomy (Bile-I 0) and blood sample again after 2-3 months at follow-up (Serum-II 0) and from fasting NC subjects. Lp(a) level was quantitated in serum and bile by immunoturbidimetric method using commercially available research kit. The results were compared statistically by ANOVA, Student's t-test and Chisquared test using SPSS programme. Results: The Lp(a) status (mg/dl, Mean ± SD) in controls and patients and their statistical analysis revealed that Lp(a) was much higher in patients compared to controls (NC: 29.07 ± 14.1, Patients Serum-I 0 : 290.84 ± 110.93, Patients Bile-I 0 : 37.12 ± 28.61, Patients Serum-II 0 : 203.70 ± 90.13) (P<0.001). Lp(a) was lowered after cholecystectomy, but remained elevated in patients Serum-II 0 compared to NC significantly (P<0.001). No significant difference was observed for Lp(a) levels between NC and patients Bile-I 0 (P=0.173). The proportions of patients for Serum-I 0 , Bile-I 0 and Serum-II 0 with Lp(a) levels above and within normal limits and their statistical analyses showed significant associations (P<0.001). Conclusions: Cholelithiasis had complex impact on Lp(a) status indicating a special function of gall bladder relevant to its metabolism. Further studies are warranted.