Background/Objective: Conventional open thyroidectomy is considered as a safe surgery nowadays. However, surgeons sometimes encounter unexpected difficulty when performing thyroidectomies. The aim of this paper was to identify the predictors of a difficult thyroidectomy for the management of patients with papillary thyroid carcinoma.
Methods: A database of patients who underwent open conventional thyroidectomy with cervical lymph node dissection after diagnosed papillary thyroid carcinoma between July 2008 and June 2013 was examined. In addition, the patients were subgrouped by difficult thyroidectomy (DT) and nondifficult thyroidectomy to determine the predictors of DT according to operation time. Clinicopathologic characteristics, surgical outcomes, and postoperative morbidities were investigated.
Results: No between-group differences in clinicopathologic factors and postoperative complications, except for male sex (p < 0.001) and tumor size (p = 0.039), were noted. Male sex [odds ratio (OR) 4.158, 95% confidence interval (CI) 2.020-8.559, p = 0.043] and age < 45 years (OR 2.239, 95% CI 1.304-3.843, p = 0.003) were independent factors associated with DT in a multivariate logistic regression model. Elevated antithyroglobulin antibody (OR 1.004, 95% CI 1.000-1.008, p = 0.030) was a variable which is statistically significant, but not clinically significant.
Discussion: Young age and male sex might be regarded as predictors of DT. Expecting DT before surgery might help surgeons, especially beginners, prevent troublesome situations. (C) 2017 Asian Surgical Association and Taiwan Robotic Surgical Association. Publishing services by Elsevier B.V.
[1]Korea Univ, Coll Med, Dept Surg, 73 Inchon Ro, Seoul 136705, South Korea.
[2]Univ Insubria, Div Surg 1, Dept Surg Sci, Endocrine Surg Res Ctr, Varese, Italy.
[3]Jilin Univ, Japan Union Hosp, Jilin Prov Key Lab Surg Translat Med, Div Thyroid Surg, Changchun, Jilin, Peoples R China.
(8.0+极速模式)