Changes in thyroid surgery over last 25 years.

Area of Science:

• Endocrinology
• Surgical Oncology
• Thyroidology

Background:

• Thyroid disorders require timely diagnosis and treatment.
• Significant advancements in thyroid disorder management have occurred over the past 25 years.
• High-volume endocrine centers are crucial for analyzing surgical trends.

Purpose of the Study:

• To analyze 25 years of thyroid surgery experience in a high-volume endocrine center.
• To evaluate demographic shifts, surgical indications, procedure types, and complication rates.
• To compare surgical outcomes between two distinct time periods (1996-2003 vs. 2011-2020).

Main Methods:

• Retrospective analysis of 3748 patients undergoing thyroid surgery from 1996-2020.
• Comparison of two periods: Period I (1996-2003) and Period II (2011-2020).
• Statistical analysis to assess changes in demographics, surgical extent, and complication rates.

Main Results:

• A statistically significant increase in thyroid cancer surgeries was observed (p < 0.00001).
• Thyroidectomy extent shifted significantly from partial to total excision (p < 0.00001).
• Recurrent laryngeal nerve palsy rates remained unchanged (p = 0.1785), but postoperative hypoparathyroidism increased (p < 0.00001).

Conclusions:

• Thyroid surgery has evolved towards more extensive procedures, particularly for thyroid cancer.
• Introduction of technologies like intraoperative nerve monitoring impacts surgical outcomes.
• While nerve preservation is maintained, careful management of hypoparathyroidism is crucial following increased total thyroidectomies.