Thyroidectomy Then and Now: A 50-Year Australian Perspective

Area of Science:

• Endocrinology
• Surgical Oncology
• Medical History

Background:

• Thyroidectomy has evolved from a high-mortality procedure to one with near-zero mortality.
• Continuous improvement in patient care remains a key goal for surgeons.
• Historical and contemporary data allow for the analysis of surgical practice evolution.

Purpose of the Study:

• To compare the practice and outcomes of thyroid surgery over a 50-year period.
• To identify trends and areas for further improvement in thyroidectomy.
• To analyze surgical indications and post-operative results across different eras.

Main Methods:

• Comparison of historical thyroidectomy cases (1946-1959) with contemporary cases (2007-2016).
• Utilized 'The Alfred Hospital Clinical Reports' for historical data.
• Analyzed surgical indications and post-operative outcomes for both cohorts.

Main Results:

• 746 historical patients vs. 787 contemporary patients; similar mean ages and gender distribution.
• Non-toxic nodular goitre was the most common indication in both periods.
• Contemporary thyroidectomy showed increased malignancy diagnosis (27% vs. 8%) and significantly reduced thyrotoxic crisis, permanent nerve palsy, and bilateral nerve palsy.
• Zero mortality in the contemporary group versus three deaths (0.44%) in the historical group.

Conclusions:

• Thyroidectomy outcomes have demonstrably improved over a 50-year span.
• The study provides unique insights into the temporal trends of thyroid surgery.
• Further advancements in thyroidectomy techniques and patient management are possible.