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J. Clin. Med. 2019, 8(4), 477; https://doi.org/10.3390/jcm8040477

Current Practice of Surgery for Benign Goitre—An Analysis of the Prospective DGAV StuDoQ|Thyroid Registry

1
Department of Visceral-, Thoracic- and Vascular Surgery, Philipps-University Marburg, 35043 Marburg, Germany
2
Department of Endocrine Surgery, Helios University Hospital Wuppertal, 42283 Wuppertal, Germany
3
Department General and Endocrine Surgery, Bürgerhospital Frankfurt/Main, 60318 Frankfurt, Germany
4
Department of Endocrine Surgery, Diakonie-Klinikum Stuttgart, 70176 Stuttgart, Germany
5
Department of Endocrine Surgery, Katholisches Klinikum Mainz, 55131 Mainz, Germany
6
German Society of General and Visceral Surgery (DGAV), 10117 Berlin, Germany
7
Department of Visceral-, Vascular and Endocrine Surgery, University Medical Centre Halle, 06120 Halle, Germany
*
Author to whom correspondence should be addressed.
Membership of the StuDoQ/Thyroid study group is provided in the Acknowledgments.
Received: 1 March 2019 / Revised: 3 April 2019 / Accepted: 4 April 2019 / Published: 8 April 2019
(This article belongs to the Section Endocrinology & Metabolism)
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Abstract

Background: To evaluate the current indications, resection strategies and short-term outcomes of surgery for benign goitre in a country with endemic goitre. Methods: Data of patients who underwent surgery for benign goitre were retrieved from the prospective StuDoQ/Thyroid registry and retrospectively analysed regarding the patient’s demographics, indications for surgery, surgical procedures, histology, and perioperative outcomes. Results: In a 15-month period, 12,888 patients from 83 departments underwent thyroid resections for benign conditions. Main indications for surgery were exclusion of malignancy (68%), compression symptoms (20.7%) and hyperthyroidism (9.7%). Preoperative fine needle aspiration cytology was performed in only 12.2% of patients with the indication “exclusion of malignancy”. Thyroidectomy (49.8%) or hemithyroidectomy (36.9%) were performed in 86.7% of patients. Minimally invasive or alternative surgical techniques were applied in only 2.2%. Intraoperative neuromonitoring was used in 98.4% of procedures, in 97.5% of patients at least one parathyroid gland was visualized, and in 15.3% of patients parathyroid tissue was autografted, respectively. The rates of unilateral and bilateral transient recurrent nerve palsy were 3.6% and 0.07% of nerves at risk, the rate of transitory hypoparathyroidism was 15.3%. The rates of postoperative bleeding and wound infections requiring reoperation were 1.4% and 0.07%, respectively. Conclusions: The indication “exclusion of malignancy” is made too liberally, and there is a strong attitude to perform complete thyroid resections. Postoperative hypoparathyroidism is the major complication after surgery for benign thyroid disease, thus requiring more awareness.
Keywords: indication; thyroid resection; registry; recurrent laryngeal nerve palsy; hypoparathyroidism indication; thyroid resection; registry; recurrent laryngeal nerve palsy; hypoparathyroidism
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Bartsch, D.K.; Dotzenrath, C.; Vorländer, C.; Zielke, A.; Weber, T.; Buhr, H.J.; Klinger, C.; Lorenz, K.; the StuDoQ/Thyroid Study Group, S.S. Current Practice of Surgery for Benign Goitre—An Analysis of the Prospective DGAV StuDoQ|Thyroid Registry. J. Clin. Med. 2019, 8, 477.

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