Increasing Use of Thyroidectomy as Definitive Treatment for Hyperthyroidism

J Surg Res. 2020 Feb;246:435-441. doi: 10.1016/j.jss.2019.09.020. Epub 2019 Oct 17.

Abstract

Background: Thyroidectomy is a definitive treatment for hyperthyroidism. The purpose of this study is to examine how often patients with hyperthyroidism are referred for thyroidectomy and what are the common reasons for referral.

Materials and methods: We identified 864 patients with hyperthyroidism diagnosis. A total of 237 patients underwent thyroidectomy from January 2011 to December 2016. Patients were divided into six groups according to the year of thyroidectomy, group 1 to group 6, from 2011 to 2016, respectively. Primary and secondary outcomes: reasons why patient was referred for thyroidectomy, time from diagnosis, and/or start of antithyroid drugs (ATDs) to thyroidectomy as well as the trend and total number of thyroidectomies each surgeon did during the study period.

Results: The mean age was 44 ± 15 y, 73% were women, and 54% were African American. A significant increase in the rate of thyroidectomy over the study period was observed where 31 patients underwent thyroidectomy in 2011 compared with 61 patients in 2016. The most common reasons patients were referred for thyroidectomy were resistance or intolerance to ATDs followed by patient's preference, and presentation with obstructive symptoms with no statistically significant difference between groups. The median time from diagnosis to surgery was 8 mo (0 to 204 mo) and 7 mo from initiation of ATDs to thyroidectomy with no significant difference between groups.

Conclusions: An increase of thyroidectomy rate was observed at our institution over the last 6 y. Patients were mostly referred due to resistance or intolerance to antithyroid medications, patients' preference of surgery, and presentation with obstructive symptoms.

Keywords: Antithyroid drugs; Hyperthyroidism; Radioactive iodine; Thyroidectomy.

MeSH terms

  • Adult
  • Antithyroid Agents / pharmacology*
  • Antithyroid Agents / therapeutic use
  • Drug Resistance
  • Female
  • Humans
  • Hyperthyroidism / therapy*
  • Iodine Radioisotopes
  • Male
  • Middle Aged
  • Patient Preference / statistics & numerical data
  • Referral and Consultation / statistics & numerical data*
  • Retrospective Studies
  • Thyroidectomy / statistics & numerical data
  • Thyroidectomy / trends*
  • Time-to-Treatment / statistics & numerical data

Substances

  • Antithyroid Agents
  • Iodine Radioisotopes