THYROID AUTO-IMMUNITY AS A RISK FACTOR FOR RECURRENT MULTINODULAR GOITER AFTER HEMITHYROIDECTOMY
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.34635/rpc.862 |
Resumo: | 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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THYROID AUTO-IMMUNITY AS A RISK FACTOR FOR RECURRENT MULTINODULAR GOITER AFTER HEMITHYROIDECTOMYAUTO-IMUNIDADE TIROIDEIA COMO FACTOR DE RISCO PARA RECORRÊNCIA DE BÓCIO MULTINODULAR APÓS LOBECTOMIABackground. 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.Introdução. A abordagem cirúrgica ideal para o tratamento do bócio multinodular (BMN) é ainda alvo de debate. A presença de auto-imunidade anti-tiroideia é um fator de risco conhecido para hipotiroidismo, podendo desempenhar um papel na fisiopatologia do BMN. Objectivo. Avaliar a auto-imunidade anti-tiroideia como fator de risco de recidiva de BMN. Métodos. Análise retrospectiva de base de dados prospectiva de todos os doentes submetidos a lobectomia tiroideia por BMN durante 5 anos (Janeiro de 2012 – Dezembro 2016). Variáveis analisadas: idade, sexo, diagnóstico pré-operatório; anticorpos anti-peroxidase (Ac TPO); anticorpos anti-tiroglobulina (Ac TG); hipotiroidismo pós-operatório; recidiva de BMN e necessidade de totalização de tiroidectomia. A recidiva foi definida como o aparecimento de novos nódulos; crescimento de > 50% de nódulos prévios ou a necessidade de totalização. Resultados. Amostra de 82 doentes; 68 mulheres e 14 homens; mediana de idade de 56,5 anos [28 – 82]. Tempo médio de follow up de 79 meses. 26% apresentaram auto-imunidade (Ac TPO ou Ac TG positivos) pré-operatoriamente. 39% necessitaram de levotiroxina pós-operatoriamente. Taxa de recidiva de 15,2%; nenhum doente necessitou de totalização. A análise univariada da relação entre auto-imunidade e recidiva foi feita através do teste de Fischer, não tendo significado estatístico (p – 0, 461). Discussão / Conclusão. A auto-imunidade anti-tiroideia não aparenta ser fator de risco para recidiva de BMN em doentes submetidos a lobectomia tiroideia. A lobectomia foi uma alternativa eficaz, com baixa taxa de recidiva, não tendo sido registado nenhum caso de necessidade de totalização.Sociedade Portuguesa de Cirurgia2022-12-09info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.34635/rpc.862https://doi.org/10.34635/rpc.862Revista Portuguesa de Cirurgia; No 53 (2022): December 2022; 23-26Revista Portuguesa de Cirurgia; No 53 (2022): December 2022; 23-262183-11651646-6918reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://revista.spcir.com/index.php/spcir/article/view/862https://revista.spcir.com/index.php/spcir/article/view/862/646Copyright (c) 2022 Revista Portuguesa de Cirurgiainfo:eu-repo/semantics/openAccessBorges, FilipeMarques, RicardoNascimento, IsabelRaimundo, LuísaPortugal, JorgeCosta, Paulo Matos2024-03-14T22:05:40Zoai:revista.spcir.com:article/862Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T04:00:57.036122Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
THYROID AUTO-IMMUNITY AS A RISK FACTOR FOR RECURRENT MULTINODULAR GOITER AFTER HEMITHYROIDECTOMY AUTO-IMUNIDADE TIROIDEIA COMO FACTOR DE RISCO PARA RECORRÊNCIA DE BÓCIO MULTINODULAR APÓS LOBECTOMIA |
title |
THYROID AUTO-IMMUNITY AS A RISK FACTOR FOR RECURRENT MULTINODULAR GOITER AFTER HEMITHYROIDECTOMY |
spellingShingle |
THYROID AUTO-IMMUNITY AS A RISK FACTOR FOR RECURRENT MULTINODULAR GOITER AFTER HEMITHYROIDECTOMY Borges, Filipe |
title_short |
THYROID AUTO-IMMUNITY AS A RISK FACTOR FOR RECURRENT MULTINODULAR GOITER AFTER HEMITHYROIDECTOMY |
title_full |
THYROID AUTO-IMMUNITY AS A RISK FACTOR FOR RECURRENT MULTINODULAR GOITER AFTER HEMITHYROIDECTOMY |
title_fullStr |
THYROID AUTO-IMMUNITY AS A RISK FACTOR FOR RECURRENT MULTINODULAR GOITER AFTER HEMITHYROIDECTOMY |
title_full_unstemmed |
THYROID AUTO-IMMUNITY AS A RISK FACTOR FOR RECURRENT MULTINODULAR GOITER AFTER HEMITHYROIDECTOMY |
title_sort |
THYROID AUTO-IMMUNITY AS A RISK FACTOR FOR RECURRENT MULTINODULAR GOITER AFTER HEMITHYROIDECTOMY |
author |
Borges, Filipe |
author_facet |
Borges, Filipe Marques, Ricardo Nascimento, Isabel Raimundo, Luísa Portugal, Jorge Costa, Paulo Matos |
author_role |
author |
author2 |
Marques, Ricardo Nascimento, Isabel Raimundo, Luísa Portugal, Jorge Costa, Paulo Matos |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Borges, Filipe Marques, Ricardo Nascimento, Isabel Raimundo, Luísa Portugal, Jorge Costa, Paulo Matos |
description |
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. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-12-09 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.34635/rpc.862 https://doi.org/10.34635/rpc.862 |
url |
https://doi.org/10.34635/rpc.862 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://revista.spcir.com/index.php/spcir/article/view/862 https://revista.spcir.com/index.php/spcir/article/view/862/646 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2022 Revista Portuguesa de Cirurgia info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2022 Revista Portuguesa de Cirurgia |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Cirurgia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Cirurgia |
dc.source.none.fl_str_mv |
Revista Portuguesa de Cirurgia; No 53 (2022): December 2022; 23-26 Revista Portuguesa de Cirurgia; No 53 (2022): December 2022; 23-26 2183-1165 1646-6918 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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