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Thyroidectomy Then and Now: A 50-Year Australian Perspective

  • Belinda Hii
  • Dominic Maher
  • Meei Yeung
  • Eldho Paul
  • Jonathan W. Serpell
  • James C. Lee
Original Scientific Report
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Abstract

Background

Since the mid-1800s, thyroidectomy has transformed from a procedure associated with high to near-zero mortality. Nonetheless, surgeons must continue to strive to improve patient care. Using historical records and contemporary data, this study compares the practice and outcomes of thyroid surgery at a tertiary institution during two periods, 50 years apart.

Methods

‘The Alfred Hospital Clinical Reports’ recorded all cases of surgically managed thyroid disease from 1946 to 1959. These historical cases were compared to contemporary thyroidectomy cases at the Alfred Hospital from 2007 to 2016. Cases were compared for surgical indication and post-operative outcomes.

Results

There were 746 patients in the historical group (mean age 53 years; 87% female) and 787 patients in the contemporary group (mean age 52 years; 80% female). The most common indication for thyroidectomy in both groups was non-toxic nodular goitre. A greater proportion of the contemporary group were diagnosed with thyroid malignancy (27% vs. 8%; p < 0.001). The contemporary group recorded significantly fewer cases of thyrotoxic crisis (2.1% vs. 0%; p = 0.001), permanent nerve palsy (4.6% vs. 0.4%; p < 0.001) and bilateral nerve palsy (1.2% vs. 0%; p = 0.01). There were no mortalities in the contemporary group, while the historical data recorded three deaths (0.44%).

Conclusions

This study compared thyroid surgery in two cohorts separated by a 50-year period. While it is not surprising that outcomes of thyroidectomy have improved, this study uniquely demonstrates trends of thyroid surgery over time and areas in which further improvements may be made.

Notes

Acknowledgements

The authors would like to acknowledge all the surgeons who have contributed cases to the MUESU database, Mr Chhavi Bhatt for maintaining the database and Dr Christine Ball for curating the historical archives.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Belinda Hii
    • 1
  • Dominic Maher
    • 1
  • Meei Yeung
    • 1
  • Eldho Paul
    • 3
    • 4
  • Jonathan W. Serpell
    • 1
    • 2
  • James C. Lee
    • 1
    • 2
  1. 1.Department of General Surgery, Monash University Endocrine Surgery UnitThe Alfred HospitalMelbourneAustralia
  2. 2.Department of SurgeryMonash UniversityMelbourneAustralia
  3. 3.Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
  4. 4.Clinical Haematology DepartmentAlfred HospitalMelbourneAustralia

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