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Recommendations Developed for Appropriate Thyroidectomy

Guidelines relate to diagnosis of thyroid disease, indications for thyroidectomy, periop management

THURSDAY, Feb. 27, 2020 (HealthDay News) — In guidelines issued by the American Association of Endocrine Surgeons, published in the March issue of the Annals of Surgery, recommendations are presented for the definitive surgical management of thyroid disease in adults.

Kepal N. Patel, M.D., from NYU Langone Health in New York City, and colleagues reviewed the medical literature to construct surgical management recommendations for thyroid disease. The recommendations focused on understanding the epidemiology and pathogenesis of thyroid disease, diagnosis of thyroid disease, indications for thyroidectomy, perioperative management, and management of thyroid cancer.

The authors note that evaluation of thyroid disease should include inquiry about personal history, family history, clinical characteristics, and symptoms. In patients with nodular thyroid disease, thyroid stimulating hormone should be measured; in specific circumstances, additional laboratory studies may help. In all patients with a suspected thyroid nodule, a diagnostic ultrasound (US) should be performed. US assessment of bilateral central and lateral lymph node compartments should and may be performed in preoperative evaluation of patients with cytologic evidence of thyroid carcinoma and with indeterminate cytologic evidence of thyroid carcinoma. In select patients with clinical suspicion for advanced locoregional thyroid cancer, computed tomography or magnetic resonance imaging with intravenous contrast should be used preoperatively as an adjunct to US. Fine-needle aspiration biopsy is a standard component for evaluation of thyroid nodule, and its indication should follow established guidelines.

“Throughout the writing process, the authors’ intent was to advise surgeons about the right thing to do for the patient,” the authors write.

Several authors disclosed financial ties to the biopharmaceutical industry.

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