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在资源有限的环境下评估甲状腺切除术患者的人口统计学特征和组织病理学模式:一项回顾性横断面研究。

Assessment of demographic characteristics and histopathological pattern of thyroidectomies patients in a resource-limited setting: a retrospective cross-sectional study.

机构信息

Department of General Surgery, School of Medicine, Ibb University of Medical Sciences, Ibb, Yemen.

Department of Urology, Urology Research Center, Al-Thora General Hospital School of Medicine, Ibb University of Medical Sciences, Ibb, Yemen.

出版信息

Pan Afr Med J. 2022 Dec 30;43:213. doi: 10.11604/pamj.2022.43.213.36495. eCollection 2022.

Abstract

Thyroid disorders are prevalent among Yemenis. However, there is limited data regarding thyroid disease burden, surgical intervention outcomes, and predictive factors in our country. This study aims to review the indications, histopathology, and complications of thyroid surgery in a resource-limited setting where the management is provided primarily by general surgeons. A retrospective study between Jun 2010 and March 2019 included 246 cases who underwent thyroid operations for a thyroid disorder in Al-Nasr Hospital, Ibb, Yemen. The patient's demographic characteristics, operative findings, complications, fine needle aspiration biopsy (FNAB) results, final pathology, and outcomes were gathered and analyzed. The mean age was 41.60± 8.31 years. The prevalence was high (30.1%) in the age group of 31-40 years and females (87.8%) with a female-to-male ratio of 7.2: 1. The main indication for thyroidectomy was compressional symptoms (35%), and the main preoperative cytology findings were multimodular goiter (89%). There was thyroid cancer in 18(7.3%) patients, and the most type was follicular thyroid carcinoma (FTC) in 9 patients. The most typical type of surgery was near-total thyroidectomy in 186 (75.6%) patients. Complications were presented in 47 patients (19.1%), and total mortality was observed in 5(2.03%) patients. Intraoperative bleeding was the most typical complication in 36 (14.6%) patients. The sensitivity, specificity, and accuracy of FNAB were 96.34%, 44.44%, and 96.34%, respectively. Fine needle aspiration biopsy (FNAB) was not precise enough in diagnosing FTC with a sensitivity of 55%. Our result showed a considerable rate of postoperative complications of thyroid surgery, and thyroidectomy may be a viable option even in a resource-limited setting or performed by general surgeons.

摘要

甲状腺疾病在也门很常见。然而,关于我们国家的甲状腺疾病负担、手术干预结果和预测因素的数据有限。本研究旨在回顾在资源有限的情况下,主要由普通外科医生提供治疗的情况下,甲状腺手术的适应证、组织病理学和并发症。一项回顾性研究,纳入了 2010 年 6 月至 2019 年 3 月期间在也门伊卜省纳斯尔医院因甲状腺疾病接受甲状腺手术的 246 例患者。收集并分析了患者的人口统计学特征、手术发现、并发症、细针穿刺活检(FNAB)结果、最终病理和结局。患者的平均年龄为 41.60±8.31 岁。31-40 岁年龄组和女性(87.8%)的患病率较高,女性与男性的比例为 7.2:1。甲状腺切除术的主要适应证是压迫症状(35%),术前细胞学检查的主要发现是多灶性甲状腺肿(89%)。18 例(7.3%)患者患有甲状腺癌,最常见的类型是滤泡状甲状腺癌(FTC),有 9 例。186 例(75.6%)患者最典型的手术类型是近全甲状腺切除术。47 例(19.1%)出现并发症,5 例(2.03%)患者死亡。36 例(14.6%)患者最典型的并发症是术中出血。FNAB 的敏感性、特异性和准确性分别为 96.34%、44.44%和 96.34%。FNAB 诊断 FTC 的敏感性为 55%,不够精确。我们的结果显示甲状腺手术后并发症的发生率相当高,即使在资源有限的情况下或由普通外科医生进行,甲状腺切除术也可能是一种可行的选择。

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