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Mixed Reality Assisted Radical Endoscopic Thyroidectomy
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Time to Hypothyroidism Following Hemithyroidectomy.

Christa R Abraham1, Ashar Ata1, Steven C Stain2

  • 1Surgery, Albany Medical College, Albany, USA.

Cureus
|January 25, 2023
PubMed
Summary

Hypothyroidism can develop after hemithyroidectomy, with 37% of patients affected. High normal preoperative thyroid stimulating hormone (TSH) levels are a key predictor of developing hypothyroidism post-surgery.

Keywords:
body mass index: bmieuthyroidhemi-thyroidectomyhypothyroidismthyroid stimulating hormone tsh

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Area of Science:

  • Endocrinology
  • Thyroid Surgery
  • Postoperative Care

Background:

  • Post-hemithyroidectomy hypothyroidism onset is variable.
  • Identifying predictors of hypothyroidism is crucial for patient management.
  • Risk factors for developing hypothyroidism require further investigation.

Purpose of the Study:

  • To determine the timing of hypothyroidism development after hemithyroidectomy.
  • To identify predictors of hypothyroidism in euthyroid patients undergoing hemithyroidectomy.
  • To analyze risk factors for early (<3 months) versus late (>3 months) hypothyroidism.

Main Methods:

  • Retrospective study of 170 euthyroid patients who had hemithyroidectomy for benign disease (2006-2014).
  • Analysis of age, gender, preoperative thyroid function tests, BMI, and comorbidities.
  • Definition of high normal preoperative TSH (HN-TSH) as ≥2.01 uIU/ml.

Main Results:

  • 37% (63/170) of patients developed hypothyroidism.
  • 21.5% were hypothyroid at 3 months, with additional cases at 6 months and 1 year.
  • High normal preoperative TSH (HN-TSH) was the sole independent predictor of hypothyroidism on multivariate analysis (p<0.001).

Conclusions:

  • BMI ≥35 kg/m², age ≥45, and preoperative HN-TSH are risk factors for early postoperative hypothyroidism.
  • These factors, alongside known predictors like remnant size and autoimmune disease, necessitate close monitoring.
  • Patients with these risk factors require vigilant follow-up to manage potential hypothyroidism after hemithyroidectomy.