Salih Abdulwahid M
Department of Surgery, College of Medicine, University of Sulaimani, Sulaymaniyah, Iraq.
J Int Med Res. 2018 Sep;46(9):3819-3823. doi: 10.1177/0300060518781228. Epub 2018 Jul 3.
Objective To investigate the prevalence of hypothyroidism following thyroid lobectomy with isthmus preservation. Methods This retrospective, case series study included patients who had undergone thyroid lobectomy with preserved isthmus that was reversed onto the contralateral lobe. Neck ultrasound was performed in all patients and the patients were followed for 2 years. Results Out of 170 patients enrolled into the study, three were excluded due to preoperative hypothyroidism and one due to isthmusectomy; of the remaining 166 included in the final analyses, 139 patients (83.7%) were female, 27 (16.3%) were male, and patient age ranged between 17 and 77 years. The indication for intervention was thyroid swelling in 141 patients (84.9%). Final diagnoses following histopathological examination comprised benign lesion in 145 cases (87.3%), malignancy (follicular carcinoma and papillary thyroid carcinoma) in 12 cases (7.2%) and thyroiditis in nine cases (5.4%). During the 2-year post-surgery follow-up, 165 patients (99.4%) were euthyroid and one patient (0.6%) developed hypothyroidism. Conclusion Postoperative hypothyroidism following thyroid lobectomy appears to be very rare when the isthmus is preserved and reversed onto the contralateral lobe.
目的 探讨保留峡部的甲状腺叶切除术后甲状腺功能减退症的患病率。方法 本回顾性病例系列研究纳入了接受甲状腺叶切除术且峡部保留并翻转至对侧叶的患者。对所有患者进行颈部超声检查,并对患者进行2年随访。结果 在纳入研究的170例患者中,3例因术前甲状腺功能减退症被排除,1例因峡部切除术被排除;最终纳入分析的166例患者中,女性139例(83.7%),男性27例(16.3%),患者年龄在17至77岁之间。141例患者(84.9%)的干预指征为甲状腺肿大。组织病理学检查后的最终诊断包括良性病变145例(87.3%)、恶性肿瘤(滤泡癌和乳头状甲状腺癌)12例(7.2%)和甲状腺炎9例(5.4%)。在术后2年的随访期间,165例患者(99.4%)甲状腺功能正常,1例患者(0.6%)出现甲状腺功能减退症。结论 当峡部保留并翻转至对侧叶时,甲状腺叶切除术后的甲状腺功能减退症似乎非常罕见。