caa a22 4500 445333936 CHVBK 20180317142747.0 cr unu---uuuuu 170323e20110901xx s 000 0 eng 10.1245/s10434-011-1627-1 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1627-1 Detection and Management of Hypothyroidism Following Thyroid Lobectomy: Evaluation of a Clinical Algorithm [Elektronische Daten] [Amanda Johner, Obi Griffith, Blair Walker, Leanne Wood, Hannah Piper, Graeme Wilkins, Christopher Baliski, Steven Jones, Sam Wiseman] Background: The objectives of this study were to determine: (1) the incidence permanent hypothyroidism after thyroid lobectomy (TL), (2) whether asymptomatic patients with mildly elevated thyrotropin (TSH) levels can be managed without thyroid hormone replacement, and (3) if the degree of lymphocytic infiltration (LI) and germinal center (GC) formation in the resected thyroid lobe correlates with the development of post-TL hypothyroidism. Methods: Subjects undergoing TL between January 2006 and January 2008 at 2 centers were enrolled in the study and thyroid function was followed prospectively based on a previously published algorithm. The histology of each resected thyroid lobe was examined, and the degree of LI and GC was quantified. Results: The study cohort consisted of 117 patients. Early postoperative TSH levels were significantly increased over preoperative levels (P<.001). TSH measured at 6months to 1year postoperatively, while still significantly increased over preoperative levels (P<.001), was also significantly reduced (P=.006) compared with early postoperative levels. Of the patients who presented with early postoperative hypothyroidism, 69.2% recovered to normal levels without intervention. The overall incidence of early postoperative hypothyroidism was 21.6%, and permanent hypothyroidism was 7.8%. A high degree of LI and GC correlated with a significantly higher mean TSH level (P=.003). Conclusions: The incidence of hypothyroidism following TL is low, and a significant proportion of individuals who become biochemically hypothyroid will demonstrate only a transient elevation in their TSH levels. As well, individuals with LI, or GC formation, within their resected thyroid lobe may be at increased risk for post-TL hypothyroidism. Society of Surgical Oncology, 2011 Johner Amanda Department of Surgery, St. Paul's Hospital & The University of British Columbia, Vancouver, BC, Canada aut Griffith Obi Department of Medical Genetics, University of British Columbia, British Columbia Cancer Agency, Vancouver, BC, Canada aut Walker Blair Department of Pathology & Laboratory Medicine, St. Paul's Hospital & The University of British Columbia, Vancouver, BC, Canada aut Wood Leanne Department of Surgery, St. Paul's Hospital & The University of British Columbia, Vancouver, BC, Canada aut Piper Hannah Department of Surgery, St. Paul's Hospital & The University of British Columbia, Vancouver, BC, Canada aut Wilkins Graeme Department of Endocrinology, St. Paul's Hospital & The University of British, Columbia, Vancouver, BC, Canada aut Baliski Christopher Department of Surgery, Kelowna General Hospital, Kelowna, BC, Canada aut Jones Steven Department of Medical Genetics, University of British Columbia, British Columbia Cancer Agency, Vancouver, BC, Canada aut Wiseman Sam Department of Surgery, St. Paul's Hospital & The University of British Columbia, Vancouver, BC, Canada aut Annals of Surgical Oncology Springer-Verlag 18/9(2011-09-01), 2548-2554 1068-9265 18:9<2548 2011 18 10434 https://doi.org/10.1245/s10434-011-1627-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1627-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Johner Amanda Department of Surgery, St. Paul's Hospital & The University of British Columbia, Vancouver, BC, Canada aut NATIONALLICENCE 700 1- Griffith Obi Department of Medical Genetics, University of British Columbia, British Columbia Cancer Agency, Vancouver, BC, Canada aut NATIONALLICENCE 700 1- Walker Blair Department of Pathology & Laboratory Medicine, St. Paul's Hospital & The University of British Columbia, Vancouver, BC, Canada aut NATIONALLICENCE 700 1- Wood Leanne Department of Surgery, St. Paul's Hospital & The University of British Columbia, Vancouver, BC, Canada aut NATIONALLICENCE 700 1- Piper Hannah Department of Surgery, St. Paul's Hospital & The University of British Columbia, Vancouver, BC, Canada aut NATIONALLICENCE 700 1- Wilkins Graeme Department of Endocrinology, St. Paul's Hospital & The University of British, Columbia, Vancouver, BC, Canada aut NATIONALLICENCE 700 1- Baliski Christopher Department of Surgery, Kelowna General Hospital, Kelowna, BC, Canada aut NATIONALLICENCE 700 1- Jones Steven Department of Medical Genetics, University of British Columbia, British Columbia Cancer Agency, Vancouver, BC, Canada aut NATIONALLICENCE 700 1- Wiseman Sam Department of Surgery, St. Paul's Hospital & The University of British Columbia, Vancouver, BC, Canada aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/9(2011-09-01), 2548-2554 1068-9265 18:9<2548 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer