The role of pre-operative investigations in deciding the outcome of thyroid surgery

Abstract

Background: Patients undergoing surgery for solitary thyroid nodules or multinodular goiter are investigated preoperatively. These investigations may define or possible cases of thyroid malignancy and so help in planning the surgical approach and affect the outcome of the management of the patient in general. Aims: To evaluate the roles played by preoperative investigations in cases of thyroid enlargement in deciding the probable outcome of the operative procedure with emphasis on cases of thyroid malignancies.Patients and Methods: All patients admitted for thyroid gland surgery at Al-Yarmouk teaching hospital for the period from Oct.1 2008 to Oct.1 2009 were fully evaluated preoperatively. Clinical, radiological, hormonal and FNA cytological findings were recorded. Operative findings were reported. Histopathological diagnosis followed and reported. Results: During the period of the study (102) patients were admitted with management, the majority were females (82) in the fourth decade of life (35 cases). The main clinical presentation was multinodular goiter (84) ultrasonography revealed (78) cystic lesions and (24) solid lesions. The main pre-operative investigation was F.N.A cytology. The majority of the reports were normal (78) with four reports of malignancy. The main finding at surgery was multinodular goiter (94 cases). The most common operative procedure was sub-total thyroidectomy (59). Histopathological examination revealed (85) benign pathology and (17) malignant all of them papillary carcinoma. Conclusions: F.N.A cytology is the most important pre-operative diagnosis and because of the reported low sensitivity further experience and training is recommended.