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Thyroid morphology and function after subtotal resection for hyperthyroidism
The British Journal of Surgery
|May 1, 1980
Summary
Thyroid surgery outcomes depend on goiter type. Toxic nodular goiter with nodular hyperplasia (TNGNH) shows lower rates of post-thyroidectomy hypothyroidism and recurrent hyperthyroidism compared to toxic diffuse goiter (TDG) and toxic nodular goiter with diffuse hyperplasia (TNGDH).
Area of Science:
- Endocrinology
- Surgical Pathology
- Thyroidology
Background:
- Hyperthyroidism presents with two main thyroid epithelial hyperplasia patterns: toxic diffuse hyperplasia and toxic nodular hyperplasia.
- These patterns influence thyroid gland morphology and can affect surgical outcomes in hyperthyroid patients.
Purpose of the Study:
- To correlate the morphological type of goiter with the development of disturbed thyroid function post-subtotal thyroidectomy.
- To assess the incidence of hypothyroidism and recurrent hyperthyroidism based on goiter histopathology.
Main Methods:
- Classification of 98 patients with toxic diffuse goiter (TDG), 58 with toxic nodular goiter and diffuse hyperplasia (TNGDH), and 105 with toxic nodular goiter and nodular hyperplasia (TNGNH).
- Follow-up assessment of thyroid function 1-6 years after subtotal thyroidectomy.
Main Results:
- Hypothyroidism developed in 22 patients with TDG and 18 (31%) with TNGDH.
- Only 3 (3%) patients with TNGNH developed hypofunction.
- Recurrent hyperthyroidism occurred in six patients, all exhibiting diffuse hyperplasia.
Conclusions:
- The histopathological type of goiter is a significant predictor of thyroid function disturbances after surgery.
- Toxic nodular goiter with nodular hyperplasia is associated with a lower risk of post-operative hypothyroidism and recurrence.