Application of Thyroid Defunctionalization Method in Endoscopic Hyperthyroidism Surgery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LINBao-hang ,  HUOHong-jun , DUANJun-ying , YUChun-liang , QIULi-juan

Breast and Thyroid Disease Center, Longgang Central Hospital, Shenzhen 518116, Guangdong Province, China;

Corresponding author：

HUOHong-jun, Email: hj_huo@163.com

Keywords：

Hyperthyroidism; Preoperative preparation; Thyroxine; Endoscope

DOI：

10.7507/1007-9424.20150160

Video：

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Objective To analyze and explore the thyroid defunctionalization method for preoperative preparation of hyperthyroidism patients in endoscopic thyroid surgery. Methods The clinical data of 45 cases of hyperthyroidism treated with endoscopic surgery in this hospital from June 2009 to June 2014 were analyzed retrospectively. These patients were divided into study group (n=20) and control group (n=25) according to the preoperative preparation method, the study group was prepared with thyroid defunctionalization method, the control group was prepared with antithyroid drugs and iodine. The intraoperative blood loss, conversion to open surgery, and postoperative complications were compared in these two groups. Results The intraoperative blood loss and the operation time of the study group were significantly less than those of the control group﹝intraoperative blood loss: (120.32±50.26) mL versus (200.63±60.95) mL, P < 0.05; operation time: (120.43±40.56) min versus (180.76±50.92) min, P < 0.05﹞. There was no case of conversion to open surgery in the study group, there were three cases of conversion to open surgery in the control group. The incidence of postoperative complications of the study group was significantly lower than that of the control group﹝10% (2/20) versus 24% (6/25), P < 0.05﹞. Conclusion Thyroid defunctionalization method is more suitable as compared with the traditional method for the preoperative preparation of hyperthyroidism in endoscopic thyroid surgery.

Citation： LINBao-hang, HUOHong-jun, DUANJun-ying, YUChun-liang, QIULi-juan. Application of Thyroid Defunctionalization Method in Endoscopic Hyperthyroidism Surgery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(5): 615-617. doi: 10.7507/1007-9424.20150160 Copy

1.	朱精强, 李志辉, 魏涛, 等.甲状腺功能衰竭法在甲状腺功能亢进手术前准备的前瞻性研究.四川大学学报:医学版, 2007, 38(5):866-870.
2.	Pedersen IB, Knudsen N, Perrild H, et al. TSH-receptor antibody measurement for differentiation of hyperthyroidism into Graves' disease and multinodular toxic goitre:a comparison of two competitive binding assays. Clin Endocrinol (Oxf), 2001, 55(3):381-390.
3.	Bahn Chair RS, Burch HB, Cooper DS, et al. Hyperthyroidism and other causes of thyrotoxicosis:management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid, 2011, 21(6):593-646.
4.	Klein I, Becker DV, Levey GS. Treatment of hyperthyroid disease. Ann Intern Med, 1994, 121(4):281-288.
5.	中华医学会内分泌学分会《中国甲状腺疾病诊治指南》编写组.中国甲状腺疾病诊治指南-甲状腺功能亢进症.中华内科杂志, 2007, 46(10):876-882.
6.	Alsanea O, Clark OH. Treatment of Graves' disease:the advantages of surgery. Endocrinol Metab Clin North Am, 2000, 29(2):321-337.
7.	Boger MS, Perrier ND. Advantages and disadvantages of surgical therapy and optimal extent of thyroidectomy for the treatment of hyperthyroidism. Surg Clin North Am, 2004, 84(3):849-874.
8.	续哲莉, 王可人, 宋昌龙, 等.甲状腺功能亢进5 365例回顾性分析.中国实用外科杂志, 2006, 26(7):506-508.
9.	Weetman AP. Graves' disease. N Engl J Med, 2000, 343(17):1236-1248.
10.	Baeza A, Aguayo J, Barria M, et al. Rapid preoperative preparation in hyperthyroidism. Clin Endocrinol (Oxf), 1991, 35(5):439-442.
11.	Wartofsky L, Glinoer D, Solomon B, et al. Differences and similarities in the diagnosis and treatment of Graves' disease in Europe, Japan, and the United States. Thyroid, 1991, 1(2):129-135.
12.	Palit TK, Miller CC 3rd, Miltenburg DM. The efficacy of thyroidectomy for Graves' disease:A meta-analysis. J Surg Res, 2000, 90(2):161-165.
13.	Sosa JA, Mehta PJ, Wang TS, et al. A population-based study of outcomes from thyroidectomy in aging Americans:at what cost? J Am Coll Surg, 2008, 206(3):1097-1105.
14.	钟先荣, 黄家平.冲击法在甲状腺功能亢进症围手术期处理中的临床应用研究.中国普外基础与临床杂志, 2012, 19(7):782-784.
15.	Weetman AP, McGregor AM. Autoimmune thyroid disease:further developments in our understanding. Endocr Rev, 1994, 15(6):788-830.
16.	Hashizume K, Ichikawa K, Sakurai A, et al. Administration of thyroxine in treated Graves' disease. Effects on the level of antibodies to thyroid-stimulating hormone receptors and on the risk of recurrence of hyperthyroidism. N Engl J Med, 1991, 324(14):947-953.
17.	Weetman AP, McGregor AM. A Autoimmune thyroid disease:further developments in our understanding. Endocr Rev, 1994, 15(6):788-830.
18.	Hüscher CS, Chiodini S, Napolitano C, et al. Endoscopic right thyroid lobectomy. Surg Endosc, 1997, 11(8):877.
19.	苏超, 王存川, 胡友主, 等.原发性甲状腺功能亢进症内镜与开放手术的临床对比研究.中国内镜杂志, 2008, 14(12):1252-1254, 1259.
20.	Alesina PF, Singaporewalla RM, Eckstein AA, et al. Is minimally invasive, video-assisted thyroidectomy feasible in Graves' disease? Surgery, 2011, 149(4):556-560.
21.	Liu S, Qiu M, Jiang DZ, et al. The learning curve for endoscopic thyroidectomy:a single surgeon's experience. Surg Endosc, 2009, 23(8):1802-1806.
22.	Choi JY, Lee KE, Chung KW, et al. Endoscopic thyroidectomy via bilateral axillo-breast approach (BABA):review of 512 cases in a single institute. Surg Endosc, 2012, 26(4):948-955.
23.	Li ZY, Wang P, Wang Y, et al. Endoscopic thyroidectomy via breast approach for patients with Graves' disease. World J Surg, 2010, 34(9):2228-2232.
24.	Ng WT. Endoscopic thyroidectomy in China. Surg Endosc, 2009, 23(7):1675-1677.
25.	Zhang W, Jiang DZ, Liu S, et al. Current status of endoscopic thyroid surgery in China. Surg Laparosc Endosc Percutan Tech, 2011, 21(2):67-71.
26.	Hassan I, Koller M, Kluge C, et al. Supervised surgical trainees perform thyroid surgery for Graves' disease safely. Langenbecks Arch Surg, 2006, 391(6):597-602.

1. 朱精强, 李志辉, 魏涛, 等.甲状腺功能衰竭法在甲状腺功能亢进手术前准备的前瞻性研究.四川大学学报:医学版, 2007, 38(5):866-870.
2. Pedersen IB, Knudsen N, Perrild H, et al. TSH-receptor antibody measurement for differentiation of hyperthyroidism into Graves' disease and multinodular toxic goitre:a comparison of two competitive binding assays. Clin Endocrinol (Oxf), 2001, 55(3):381-390.
3. Bahn Chair RS, Burch HB, Cooper DS, et al. Hyperthyroidism and other causes of thyrotoxicosis:management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid, 2011, 21(6):593-646.
4. Klein I, Becker DV, Levey GS. Treatment of hyperthyroid disease. Ann Intern Med, 1994, 121(4):281-288.
5. 中华医学会内分泌学分会《中国甲状腺疾病诊治指南》编写组.中国甲状腺疾病诊治指南-甲状腺功能亢进症.中华内科杂志, 2007, 46(10):876-882.
6. Alsanea O, Clark OH. Treatment of Graves' disease:the advantages of surgery. Endocrinol Metab Clin North Am, 2000, 29(2):321-337.
7. Boger MS, Perrier ND. Advantages and disadvantages of surgical therapy and optimal extent of thyroidectomy for the treatment of hyperthyroidism. Surg Clin North Am, 2004, 84(3):849-874.
8. 续哲莉, 王可人, 宋昌龙, 等.甲状腺功能亢进5 365例回顾性分析.中国实用外科杂志, 2006, 26(7):506-508.
9. Weetman AP. Graves' disease. N Engl J Med, 2000, 343(17):1236-1248.
10. Baeza A, Aguayo J, Barria M, et al. Rapid preoperative preparation in hyperthyroidism. Clin Endocrinol (Oxf), 1991, 35(5):439-442.
11. Wartofsky L, Glinoer D, Solomon B, et al. Differences and similarities in the diagnosis and treatment of Graves' disease in Europe, Japan, and the United States. Thyroid, 1991, 1(2):129-135.
12. Palit TK, Miller CC 3rd, Miltenburg DM. The efficacy of thyroidectomy for Graves' disease:A meta-analysis. J Surg Res, 2000, 90(2):161-165.
13. Sosa JA, Mehta PJ, Wang TS, et al. A population-based study of outcomes from thyroidectomy in aging Americans:at what cost? J Am Coll Surg, 2008, 206(3):1097-1105.
14. 钟先荣, 黄家平.冲击法在甲状腺功能亢进症围手术期处理中的临床应用研究.中国普外基础与临床杂志, 2012, 19(7):782-784.
15. Weetman AP, McGregor AM. Autoimmune thyroid disease:further developments in our understanding. Endocr Rev, 1994, 15(6):788-830.
16. Hashizume K, Ichikawa K, Sakurai A, et al. Administration of thyroxine in treated Graves' disease. Effects on the level of antibodies to thyroid-stimulating hormone receptors and on the risk of recurrence of hyperthyroidism. N Engl J Med, 1991, 324(14):947-953.
17. Weetman AP, McGregor AM. A Autoimmune thyroid disease:further developments in our understanding. Endocr Rev, 1994, 15(6):788-830.
18. Hüscher CS, Chiodini S, Napolitano C, et al. Endoscopic right thyroid lobectomy. Surg Endosc, 1997, 11(8):877.
19. 苏超, 王存川, 胡友主, 等.原发性甲状腺功能亢进症内镜与开放手术的临床对比研究.中国内镜杂志, 2008, 14(12):1252-1254, 1259.
20. Alesina PF, Singaporewalla RM, Eckstein AA, et al. Is minimally invasive, video-assisted thyroidectomy feasible in Graves' disease? Surgery, 2011, 149(4):556-560.
21. Liu S, Qiu M, Jiang DZ, et al. The learning curve for endoscopic thyroidectomy:a single surgeon's experience. Surg Endosc, 2009, 23(8):1802-1806.
22. Choi JY, Lee KE, Chung KW, et al. Endoscopic thyroidectomy via bilateral axillo-breast approach (BABA):review of 512 cases in a single institute. Surg Endosc, 2012, 26(4):948-955.
23. Li ZY, Wang P, Wang Y, et al. Endoscopic thyroidectomy via breast approach for patients with Graves' disease. World J Surg, 2010, 34(9):2228-2232.
24. Ng WT. Endoscopic thyroidectomy in China. Surg Endosc, 2009, 23(7):1675-1677.
25. Zhang W, Jiang DZ, Liu S, et al. Current status of endoscopic thyroid surgery in China. Surg Laparosc Endosc Percutan Tech, 2011, 21(2):67-71.
26. Hassan I, Koller M, Kluge C, et al. Supervised surgical trainees perform thyroid surgery for Graves' disease safely. Langenbecks Arch Surg, 2006, 391(6):597-602.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of Thyroid Defunctionalization Method in Endoscopic Hyperthyroidism Surgery

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