Identifying Predictors of a Difficult Thyroidectomy

Mok, Valerie M.; Oltmann, Sarah C.; Chen, H.; Sippel, Rebecca S.

doi:10.1016/j.jss.2013.11.481

Cited by 1 publication

(2 citation statements)

References 35 publications

(49 reference statements)

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“…18 The Thyroidectomy Difficulty Scale, developed by Schneider and colleagues incorporates all of these aspects of difficulty -vascularity, friability, mobility and gland size -to create a single composite score of difficulty. 1,2 Preoperative variables that predict a difficult thyroid surgery were identified using the Thyroidectomy Difficulty Scale. Hyperthyroidism (TSH <0.4 mIU/L), Hashimoto's thyroiditis (anti-thyroid peroxidase antibody is >30 IU/ml), and pre-operative anti-thyroglobulin antibody positivity (greater than 4 IU/ml) were associated with a more difficult thyroidectomy.…”

Section: During the Late 19mentioning

confidence: 99%

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Predicting difficulty of thyroidectomy preoperatively

Oommen

Remin

2017

Int Surg J

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Background: Today, thyroidectomy is a common operation used to treat various thyroid disorders. Nowadays, many high-volume thyroid surgeons are discharging patients on the same day of thyroidectomy. The incidence of complications following thyroidectomy is directly linked to the difficulty of the procedure. So, if we can predict the difficulty of thyroidectomy preoperatively, we can anticipate complications and decide on which patients will require in-patient care.Methods: A thyroidectomy difficulty scale was developed by Schneider and colleagues. This scale was used in our study to classify patients in to difficult thyroidectomy group and non-difficult thyroidectomy group. The association between preoperative variables and difficulty of thyroidectomy was studied.Results: Statistical analysis revealed that there was a significant association between hyperthyroidism and difficult thyroidectomy. Similarly, there was a significant association between positive anti-thyroid peroxidase antibody (which defines Hashimoto’s thyroiditis) and difficult thyroidectomy. Also, there was a significant association between positive anti-thyroglobulin antibody and difficult thyroidectomy. Difficult thyroidectomy was found to have a significant association with postoperative hypocalcemia. Statistical analysis also showed duration of surgery to have a significant association with difficulty of thyroidectomyConclusions: Patients with hyperthyroidism, positive anti-thyroid peroxidase antibodies, positive anti-thyroglobulin antibodies have a high probability of a difficult thyroidectomy, associated with longer operative times and increased complications. This information can improve preoperative risk counseling and lead to more efficient scheduling of the operating room.

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Section: During the Late 19mentioning

confidence: 99%

“…After thyroidectomy, the surgeons completed the TDS. 1,2 In present study, a modification of the above scale was used for convenience.…”

Section: Introductionmentioning

confidence: 99%