pattern of thyroid disease undergoing surgery in Kasr El Aini hospital during 1997

ABSTRACT

Diseases of the thyroid gland are common in our society. Moreover, it constitutes a significant percentage of our practice in the Department of Surgery, Kasr El Aini Hospital, Cairo University. Surgical procedures involving the thyroid gland accounts for about 6 percent of the operation list workload. In this study, we evaluated the pattern of thyroid disease managed in the Department of General Surgery. The diagnostic criteria, investigations, indications for surgery, surgical procedures and histopathological data were analyzed, tabulated and discussed. The study included 307 patients, admitted to the Hospital during 1997. The age range was 18 to 65 years with the mean of 38 +/- 11.4 years and 260[84.7%] of patients were females. Three hundred and seven thyroid operations were performed. Adenomatous goiter was the most common histological finding, it accounted for 61.2% of all specimens included in the study. Benign solitary thyroid pathology was found in 16.3% of the specimens examined and malignancy in 7.2% of the specimens examined. Thyrotoxicosis and Hashimoto's thyroiditis accounted for 13% and 2.3% respectively. Correlation of histological analysis and the type of operation suggested that a variety of operations were performed for the same pathological condition and that some operations were only diagnostic procedures. Forty-two thyroid Fine Needle Aspiration Cytology [FNAC] were performed to evaluate clinically suspicious lesions. From our study, we conclude that, malignancy accounted for a significant percentage among our patients. The role of thyroid function tests and radioactive thyroid scans are well established in our practice. The implementation of neck ultrasonography and FNAC in the management of thyroid disease in Kasr El Aini Hospital is increasing. The predictive values are in continuous improvement and coupled with the international standardized diagnostic protocols