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Changing trends in thyroid surgery. 38 years' experience.

J W Galloway1, A Sardi, R W DeConti

  • 1Department of Surgery, Ochsner Clinic, New Orleans, Louisiana.

The American Surgeon
|January 11, 1991
PubMed
Summary
This summary is machine-generated.

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Fine needle aspiration (FNA) of thyroid masses has become a common diagnostic tool. Its increased use correlates with fewer surgeries, a higher cancer detection rate, and improved patient outcomes.

Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Pathology

Background:

  • Fine needle aspiration (FNA) has evolved from an uncommon to a standard diagnostic procedure for thyroid nodules.
  • Thyroid surgery trends have historically been influenced by diagnostic capabilities.

Purpose of the Study:

  • To analyze changes in thyroid surgery volume and pathology over 38 years.
  • To evaluate the impact of increased Fine Needle Aspiration (FNA) utilization on surgical practices and outcomes.

Main Methods:

  • Retrospective review of 509 thyroid surgery cases.
  • Analysis of surgical case numbers and procedure types across 2-year intervals per decade from 1950 to 1988.

Main Results:

  • A significant decrease in total thyroid surgery cases was observed in 1987-1988 compared to previous periods.

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  • The proportion of thyroidectomies performed for carcinoma increased substantially, from 6.3% to 46.7% during the study period.
  • Surgical complications decreased from an average of 4.5% to 1.6%.

    • Conclusions:

    • Increased adoption of FNA has led to a more selective surgical approach for thyroid masses.
    • FNA improves preoperative diagnostic accuracy, increasing the yield of malignancy in surgical cases and reducing unnecessary surgeries.
    • The study demonstrates a reduction in surgical complications and an increase in total thyroidectomies performed, reflecting improved patient selection.