Browse > Article

Clinical Significance of Nodulectomy in Surgical Treatment of Benign Thyroid Nodules  

Lee, Dong-Woo (Department of Surgery, College of Medicine, Inje University, Busan Paik Hospital)
Kim, Sang-Hyo (Department of Surgery, College of Medicine, Inje University, Busan Paik Hospital)
Publication Information
Korean Journal of Head & Neck Oncology / v.22, no.2, 2006 , pp. 137-141 More about this Journal
Abstract
Purpose : It has been generally accepted that lobectomy is a standard surgical procedure in treatment of benign thyroid nodules. However lobectomy may cause postoperative hypothyroidism. Most of surgeons believe that nodulectomy has its limitation in treatment of thyroid nodules due to recurrence of nodules and presence of cancer. The current study attempts to determine whether nodulectomy is justified in aspects of preservation of thyroid function, risk of recurrence and complications. Methods: Data was collected retrospectively on 74 patients undergoing thyroidectomy(single nodulectomy, n=43;bilateral nodulectomies, n=9;lobectomy with nodulectomy, n=22) for benign thyroid nodules from 1999 to 2004. All patients were evaluated for complication, postoperative thyroid function, and recurrence of benign nodule and cancer were followed by regular ultrasonographic examination for 2-6 years. Results : The pathologic results of 74 patients were nodular hyperplasia(55 patients), Hashimoto's thyroiditis(8 patients), follicular adenoma(7 patients) and papillary carcinoma(4 patients). Average operation time was 30 minutes from skin incision to specimen out. In postoperative follow-up of 70 patients, six cases(8.5%) became mild hypothyroid, and ultrasonographically detected micronodule was also six cases(8.5%). There were no other complications. Conclusion : Thyroid nodulectomy appears to have advantages of relatively few complication and simple procedure with no access to laryngeal nerves. Therefore, it may be one of treatment options in selected cases of benign thyroid nodules.
Keywords
Thyroid nodules; Nodulectomy; Recurrence; Hypothyroidism;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Zelmanovitz T, Zelmanovitz F, Genro S, Gus P, de Azevedo MJ, Gross JL: Analysis of the factors associated with recurrence of post-thyroidectomy goiter. Rev Assoc Med Bras. 1995;41:86-90
2 Lasagna B, Resegotti A, De Paolis P, Balbo G: Extension of thyroidectomy in the treatment of benign nodular thyroid diseases. Minerva Chir. 1993;48:1421-1424
3 Date J, Feldt-Rasmussen U, Blichert-Toft M, Hegedus L, Graversen HP: Long-term observation of serum thyroglobulin after resection of nontoxic goiter and relation to ultrasonographically demonstrated relapse. World J Surg. 1996;20:351-356   DOI
4 Buchanan MA, Lee D: Thyroid auto-antibodies, lymphocytic infiltration and the development of post-operative hypothyroidism following hemithyroidectomy for non-toxic nodular goitre. J R Coll Surg Edinb. 2001;46:86-90
5 Gibelin H, Sierra M, Mothes D, Ingrand P, Levillain P, Jones C, et al: Risk factors for recurrent nodular goiter after thyroidectomy for benign disease: case-control study of 244 patients. World J Surg. 2004;28:1079-1082   DOI
6 Basili G, Biagini C, Manetti A, Martini F, Biliotti G: Risk of recurrence following partial thyroidectomy for benign lesions. Report of 58 patients 15-25 years after surgery. Minerva Chir. 2003;58:321-329
7 Berglund J, Bondesson L, Christensen SB, Larsson AS, Tibblin S: Indications for thyroxine therapy after surgery for nontoxic benign goitre. Acta Chir Scand. 1990;156:433-438
8 Marchesi M, Nuccio G, Faloci C, De Cristofaro F: Recurrences after thyroid lobectomy for benign thyroid diseases: analysis of a clinical-instrumental follow up. Ann Ital Chir. 1998;69:581-586
9 Greisen O: A nodule in the thyroid gland. Preoperative examinations and treatment-an analysis of 990 cases. Ugeskr Laeger. 2003;165:1031-1034
10 Piper HG, Bugis SP, Wilkins GE, Walker BAM, Wiseman S, Baliski CR: Detecting and defining hypothyroidism after hemithyroidectomy. Am J Surg. 2005;189:587-591   DOI   ScienceOn
11 Porzio S, Mariani LM, Gardi G, Lombardi V: Surgical treatment of solitary thyroid nodule. Chir Ital. 2002;54:799-805
12 Shaha AR, Shah JP, Loree TR: Low-risk differentiated thyroid cancer: the need for selective treatment. Ann Surg Oncol. 1997;4:328-333   DOI   ScienceOn
13 McHenry CR, Slusarczyk SJ: Hypothyroidisim following hemithyroidectomy: incidence, risk factors, and management. Surgery. 2000;128:994-998   DOI   ScienceOn
14 Welker MJ, Orlov D: Thyroid nodules. Am Fam Physician. 2003;67:559-566
15 Bourquiqnat E, Bunault S, Mayaux MJ: Conditions of the remaining thyroid tissue after partial thyroidectomy. Ann Otolaryngol Chir Cervicofac. 1995;112:330-335
16 McCall A, Jarosz H, Lawrence AM: The incidence of thyroid carcinoma in solitary cold nodules and in multinodular goiters. Surgery. 1986;100:1128-1132
17 Ambrosi A, Pezzolla A, Barone G, Quaranta G, Errico D, Iacobone M, et al: Clinical study of residual function and recurrences in patients after partial thyroidectomy for non-toxic nodular goiter. Ann Ital Chir. 1994;65:543-546
18 Dvorak J, Vlcek P, Neumann J, Smutny S, Pilous D: Surgical treatment of benign tumors of the thyroid gland. Rozhl Chir. 1999;78:16-20