THYROID AUTO-IMMUNITY AS A RISK FACTOR FOR RECURRENT MULTINODULAR GOITER AFTER HEMITHYROIDECTOMY
Background. The ideal surgical strategy to multinodular goiter (MNG) is currently still matter of discussion. Thyroid auto- immunity is a well-known risk factor for hypothyroidism and could play a role in MNG’s physiopathology. Objective. Assess thyroid auto-immunity as a risk factor for MNG recurrence.
Materials and Methods. Retrospective analysis of a 5-year (January 2012 – December 2016) prospective database of all patients submitted to hemythyroidectomy for MNG. Variables: age, gender, preoperative diagnosis, anti-peroxidase and anti-thyroglobulin antibodies (anti-TPO and anti-Tg); postoperative L-thyroxin therapy, MNG recurrence, contralateral thyroidectomy. MNG recurrence was defined as the need for complementary contralateral lobectomy, or the appearance of new nodules, or an increase in size of at least 50% of the nodules in the remnant lobe.
Results. 82 patients included. Median follow-up time of 49 months [33 –88]. Thyroid auto-immunity (anti-TPO and/or anti-Tg) was present in 26% of the patients. 39% of the patients required replacement postoperative L-thyroxin therapy. Recurrence of MNG was observed in 15,2% of the patients but none required contralateral thyroidectomy. Univariate analysis did not show a statistical significant relationship between thyroid autoimmunity and MNG recurrence (p – 0, 461).
Discussion / Conclusion. Thyroid autoimmunity dos not seem to represent a risk factor for MNG recurrence after hemythyroidectomy. This surgical approach was effective, with a low recurrence rate. Also the clinical impact of such recurrence was low with no patient needing contralateral resection.
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