Thyroid function after resection for non-toxic goitre with special reference to thyroid lymphocytic aggregation and...

Area of Science:

• Endocrinology
• Surgical Oncology
• Thyroidology

Background:

• Non-toxic goitre is a common endocrine disorder requiring surgical intervention.
• Post-operative thyroid function monitoring is crucial after goitre resection.
• Understanding long-term thyroid function post-surgery informs treatment protocols.

Purpose of the Study:

• To evaluate thyroid function up to 24 months post-surgery in patients with non-toxic goitre.
• To identify risk factors for post-operative thyroid dysfunction.
• To determine the necessity of routine thyroid hormone replacement therapy.

Main Methods:

• Systematic follow-up of 91 patients for 24 months post-thyroidectomy for non-toxic goitre.
• Assessment of thyroid remnant size, thyroid stimulating hormone (TSH), free thyroxine index (FT4I), and total triiodothyronine (TT3) levels.
• Histopathological grading for lymphocytic infiltration and pre-operative antibody determination.

Main Results:

• A transient increase in serum TSH was observed, normalizing by 24 months, with slight elevations in 9% of patients (bilateral surgery, high lymphocytic infiltration).
• Serum FT4I returned to baseline, while serum TT3 remained lower than pre-operative levels, though all patients remained euthyroid.
• Post-operative thyroid function was not correlated with the presence of thyroid autoantibodies.

Conclusions:

• Routine thyroid hormone replacement therapy is generally not indicated after non-toxic goitre resection.
• Caution is advised for patients undergoing bilateral resection with high lymphocytic infiltration.
• Long-term monitoring is essential to detect subtle thyroid function changes.