THE VALUE OF PERFORMING EARLY TOTAL THYROIDECTOMY IN HASHIMOTO THYROIDITIS PATIENTS.
- Department of General Surgery, Zagazig University Faculty of Medicine, Zagazig, Egypt.
- Department of Pathology, Zagazig University Faculty of Medicine, Zagazig, Egypt.
- Abstract
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- Corresponding Author
The purpose of this study was to identify the value of performing total thyroidectomy in Hashimoto?s thyroiditis (HT) patients with persistent preoperative symptoms despite conservative medical therapy. Additionally to identify the value of performing early total thyroidectomy in HT patients with mild to moderate preoperative symptoms without depending on medical therapy and detect the frequency of improvement of the symptoms after thyroidectomy in both conditions. Methods: we have included 60 patients in our study who were diagnosed clinically and laboratory as having HT we divided all patients into 2 groups group 1 included 30 patients who were subjected to early total thyroidectomy and group 2 that included 30 patients and subjected to supervision and follow-up of clinical and laboratory symptoms without performing total thyroidectomy. Patients of group 1 were subjectively evaluated for occurrence of postoperative improvement, relief of symptoms or occurrence of complications. Results: we detected that there is marked improvement in post- thyroidectomy in patients of group 1 in clinical annoying symptoms; serious tiredness, compression, voice problems (p<0.001), and there is marked improvement in level of antibody titers after follow-up; anti-TPO antibodies, high anti-TG antibodies (p<0.001). In group 2 patients; we detected that there is marked deterioration in clinical annoying symptoms; serious tiredness, compression, voice problems (p<0.001), and there is marked increasing in level of antibody titers after follow-up; anti-TPO antibodies, high anti-TG antibodies (p<0.001). Conclusion: we have proved that total thyroidectomy for management of HT patients is an operation that can be safely performed, with low incidence of permanent complications. Therefore, HT patients will be advised to do Total Thyroidectomy early in such patients that will make antibodies disappear, improve autoimmune symptoms and decrease the incidence of postoperative complications.
- Thomas CG, Rutledge RG. Surgical intervention in chronic (Hashimoto?s) Thyroiditis. Ann Surg. 1981; 193:769?776. [PubMed: 6894684]
- Repplinger D, Bargren A, Zhang Y, Adler J, Haymart M, Chen H. Is Hashimoto?s thyroiditis a risk factor for papillary thyroid cancer? J Surg Res. 2008; 150:49?52. [PubMed: 17996901]
- Gasbarri A, Sciacchitano S, Marasco A, Papotti M, et al. Detection and molecular characterization of thyroid cancer precursor lesions in a specific subset of Hashimoto?s thyroiditis. British J of Cancer. 2004; 91:1096?1104.
- Beobachtungen K. Indication of operation in various forms of Hashimoto?s thyroiditis. Clinical observations. Munch Med Wochenschr. 1975; 117(13):543?6.
- Stoll SJ, Pitt SC, Liu J, Schaefer S, Sippel RS, Chen H. Thyroid hormone replacement after thyroid lobectomy. Surgery. 2009; 146(4):558?60.
- Shih ML, Lee JA, Hsieh CB, et al. Thyroidectomy for Hashimoto?s thyroiditis: complications and associated cancers. Thyroid. 2008; 18(7):729?34. [PubMed: 18631001]
- Shimizu K, Nakajima Y, Kitagawa W, Akasu H, et al. Surgical therapy in Hashimoto?s thyroiditis. J Nippon Med Sch. 2003; 70(1):34?9. [PubMed: 12646974].
- Zaletel K. Determinants of thyroid autoantibody production in Hashimoto?s thyroiditis. Exp Rev of Clin Immunol. 2007; 3(2):217?23.
- Tajiri J. Radioactive iodine therapy for goitrous Hashimoto?s thyroiditis. J Clin Endocrinol Metab. 2006; 91(11):4497?500. [PubMed: 16895949].
- Cipolla C, Sandonato L, Graceffa G. Hashimoto thyroiditis coexistent with papillary thyroid carcinoma. Am Surg. 2005; 71:874?8. [PubMed: 16468540]
- Gyory F, Lukacs G, Juhasz F, et al. surgically treated Hashimoto?s thyroiditis. Acta Chir Hung. 1999; 38(3?4):243?7. [PubMed: 10935132]
- Haymart MR, Repplinger DJ, Leverson GE, Elson DF, Sippel RS, Jaume JC, Chen H. Higher Serum TSH Level in Thyroid Nodule Patients is Associated with Greater Risks of Differentiated Thyroid Cancer and Advanced Tumor Stage. Journal of Clinical Endocrinology and Metabolism. 2008; 93:809?14. [PubMed: 18160464].
- Catherine McManus, B.S., Jie Luo, B.S., Rebecca Sippel, M.D., F.A.C.S., and Herbert Chen, M.D., F.A.C.S Should Patients with Symptomatic Hashimoto?s Thyroiditis Pursue Surgery? J Surg Res. 2011 September; 170(1): 52?55. doi:10.1016/j.jss.2011.01.037.
- Catherine McManus, B.S., Jie Luo, B.S., Rebecca Sippel, M.D., F.A.C.S., and Herbert Chen, M.D., F.A.C.S. Is Thyroidectomy in Patients with Hashimoto?s Thyroiditis More Risky?? J Surg Res. 2012 December; 178(2): 529?532. doi:10.1016/j.jss.2012.09.017.
- PIETRO ACCETTA, TCBC-RJ 1; ITALO ACCETTA TCBC-RJ 1; ANTONIO CARLOS ACCETTA TCBC-RJ 1; MARCELO S? DE ARA?JO TCBC-RJ 1; RENATO ACCETTA 1; KEILA BORBA CAMPOS 2 Total thyroidectomy for benign thyroid diseases Rev. Col. Bras. Cir. 2011; 38(4): 223-226
- Nenkov R, Radev R, Khristozoc K, Kuzmanov Ia, et al. Hashimoto?s thyroiditis: indications for surgical treatment. Khirurgiia(Sofiia). 2005; (3):28?32.
- Kurukahvecioglu O, Taneri F, Yuksel O, et al. Total thyroidectomy for the treatment of Hashimoto?s thyroiditis coexisting with papillary thyroid carcinoma. Adv Ther. 2007; (3):510? 516. [PubMed: 17660159]
[Ramadan Mahmoud, Ahmed Raafat, Hazem Nour, Loay M. Gertallah and Mohamed Ali Alabiad. (2018); THE VALUE OF PERFORMING EARLY TOTAL THYROIDECTOMY IN HASHIMOTO THYROIDITIS PATIENTS. Int. J. of Adv. Res. 6 (Feb). 69-78] (ISSN 2320-5407). www.journalijar.com
Department of General Surgery, Zagazig University Faculty of Medicine, Zagazig, Egypt