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Article: Effect of Thyroid Remnant Volume on the Risk of Hypothyroidism After Hemithyroidectomy: A Prospective Study
Title | Effect of Thyroid Remnant Volume on the Risk of Hypothyroidism After Hemithyroidectomy: A Prospective Study |
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Authors | |
Issue Date | 2017 |
Citation | Annals of Surgical Oncology, 2017, v. 24, p. 1525-1532 How to Cite? |
Abstract | Background: Hypothyroidism is a common sequel after a hemithyroidectomy. Although various risk factors leading to hypothyroidism have been reported, the effect of the contralateral lobe’s volume has been understudied. This study aimed to examine the association between the preoperative contralateral lobe’s volume and the risk of postoperative hypothyroidism. Methods: During a 2-year period, 150 eligible patients undergoing a hemithyroidectomy were evaluated. The volume of the contralateral nonexcised lobe was estimated preoperatively by independent assessors on ultrasonography using the following formula: width (in cm) × depth (in cm) × length (in cm) × (π/6), adjusted for the body surface area (BSA). Postoperative hypothyroidism was defined as serum thyroid-stimulating hormone (TSH) exceeding 4.78 mIU/L. Any significant characteristics in the univariate analysis were entered into the multivariate analysis to determine independent factors. Results: After a mean follow-up period of 53.5 ± 9.4 months, 44 patients (29.3 %) experienced postoperative hypothyroidism, and 10 of these patients required thyroxine replacement. Hypothyroidism was associated with a higher preoperative TSH level (p < 0.001), a smaller BSA-adjusted volume (p < 0.001), fewer ipsilateral nodules (p = 0.037), and the presence of thyroiditis (p = 0.050). After adjustment for thyroiditis, preoperative TSH (p < 0.001), number of ipsilateral nodules (p = 0.048), and BSA-adjusted volume (p < 0.001) were independent factors for hypothyroidism. Patients with a BSA-adjusted volume smaller than 3.2 ml had a threefold greater hypothyroidism risk than those with a BSA-adjusted volume of 3.2 ml or more (p < 0.001). Conclusions: A significant inverse association between the preoperative contralateral lobe’s volume and hypothyroidism risk was observed after hemithyroidectomy. Together with a higher preoperative TSH level and fewer ipsilateral nodules, a smaller BSA-adjusted volume measured by preoperative ultrasonography independently predicted hypothyroidism. |
Persistent Identifier | http://hdl.handle.net/10722/237760 |
ISSN | 2023 Impact Factor: 3.4 2023 SCImago Journal Rankings: 1.037 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Lang, HHB | - |
dc.contributor.author | Wong, CKH | - |
dc.contributor.author | Wong, KP | - |
dc.contributor.author | Chu, KKW | - |
dc.contributor.author | Shek, TWH | - |
dc.date.accessioned | 2017-01-20T02:28:08Z | - |
dc.date.available | 2017-01-20T02:28:08Z | - |
dc.date.issued | 2017 | - |
dc.identifier.citation | Annals of Surgical Oncology, 2017, v. 24, p. 1525-1532 | - |
dc.identifier.issn | 1068-9265 | - |
dc.identifier.uri | http://hdl.handle.net/10722/237760 | - |
dc.description.abstract | Background: Hypothyroidism is a common sequel after a hemithyroidectomy. Although various risk factors leading to hypothyroidism have been reported, the effect of the contralateral lobe’s volume has been understudied. This study aimed to examine the association between the preoperative contralateral lobe’s volume and the risk of postoperative hypothyroidism. Methods: During a 2-year period, 150 eligible patients undergoing a hemithyroidectomy were evaluated. The volume of the contralateral nonexcised lobe was estimated preoperatively by independent assessors on ultrasonography using the following formula: width (in cm) × depth (in cm) × length (in cm) × (π/6), adjusted for the body surface area (BSA). Postoperative hypothyroidism was defined as serum thyroid-stimulating hormone (TSH) exceeding 4.78 mIU/L. Any significant characteristics in the univariate analysis were entered into the multivariate analysis to determine independent factors. Results: After a mean follow-up period of 53.5 ± 9.4 months, 44 patients (29.3 %) experienced postoperative hypothyroidism, and 10 of these patients required thyroxine replacement. Hypothyroidism was associated with a higher preoperative TSH level (p < 0.001), a smaller BSA-adjusted volume (p < 0.001), fewer ipsilateral nodules (p = 0.037), and the presence of thyroiditis (p = 0.050). After adjustment for thyroiditis, preoperative TSH (p < 0.001), number of ipsilateral nodules (p = 0.048), and BSA-adjusted volume (p < 0.001) were independent factors for hypothyroidism. Patients with a BSA-adjusted volume smaller than 3.2 ml had a threefold greater hypothyroidism risk than those with a BSA-adjusted volume of 3.2 ml or more (p < 0.001). Conclusions: A significant inverse association between the preoperative contralateral lobe’s volume and hypothyroidism risk was observed after hemithyroidectomy. Together with a higher preoperative TSH level and fewer ipsilateral nodules, a smaller BSA-adjusted volume measured by preoperative ultrasonography independently predicted hypothyroidism. | - |
dc.language | eng | - |
dc.relation.ispartof | Annals of Surgical Oncology | - |
dc.title | Effect of Thyroid Remnant Volume on the Risk of Hypothyroidism After Hemithyroidectomy: A Prospective Study | - |
dc.type | Article | - |
dc.identifier.email | Lang, HHB: Blang@hku.hk | - |
dc.identifier.email | Wong, CKH: carlosho@hku.hk | - |
dc.identifier.email | Wong, KP: kpwongb@hku.hk | - |
dc.identifier.authority | Lang, HHB=rp01828 | - |
dc.identifier.authority | Wong, CKH=rp01931 | - |
dc.identifier.authority | Wong, KP=rp02007 | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1245/s10434-016-5743-9 | - |
dc.identifier.scopus | eid_2-s2.0-85008516525 | - |
dc.identifier.hkuros | 271041 | - |
dc.identifier.volume | 24 | - |
dc.identifier.spage | 1525 | - |
dc.identifier.epage | 1532 | - |
dc.identifier.eissn | 1534-4681 | - |
dc.identifier.isi | WOS:000400615200012 | - |
dc.identifier.issnl | 1068-9265 | - |