Hemodynamic Instability during Thyroidectomy in Graves’ Disease
Background The aim of this study was to investigate the changes in vital signs and hemodynamic status that occur in patients during the intraoperative course of thyroidectomy in Graves’ Disease (GD). Methods A total of 71 patients were included in the study. Patients were directed to surgery when th...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-02-01
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| Series: | Journal of Investigative Surgery |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/08941939.2021.1914785 |
| _version_ | 1797684467513425920 |
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| author | Sami Acar Candas Ercetin Nuri Alper Sahbaz Fırat Tutal Yunus Yapalak Fulya Cosan Yesim Erbil |
| author_facet | Sami Acar Candas Ercetin Nuri Alper Sahbaz Fırat Tutal Yunus Yapalak Fulya Cosan Yesim Erbil |
| author_sort | Sami Acar |
| collection | DOAJ |
| description | Background The aim of this study was to investigate the changes in vital signs and hemodynamic status that occur in patients during the intraoperative course of thyroidectomy in Graves’ Disease (GD). Methods A total of 71 patients were included in the study. Patients were directed to surgery when they had large goiters with compressive symptoms or suspicious nodules, were pregnant or lactating, were unresponsive or intolerant to antithyroid drugs (ATDs), or expressed a preference to have surgery. All patients scheduled for operations underwent surgery while in the euthyroid state. Results Hemodynamic instability was observed in 18 patients during thyroidectomy. Disease duration, sample weight, and thyroid-stimulating hormone receptor antibodies (TRAb) levels were found to be effective on hemodynamic instability. Logistic regression analysis revealed an 11-fold increase in the instability risk in patients with a period of disease shorter than 21 months (P = 0.037). A TRAb value >11.5 increased the risk by 235fold (p < 0.001). Conclusion High levels of TRAb values and new onset of disease with shorter periods of ATDs use may be risk factors for hemodynamic instability during thyroidectomy. Patients with larger thyroid glands are at greater risk for instability during surgery. Those risks should be taken into account during surgery, and the surgical and anesthetic management of the patient should be made more carefully in concordance with the anesthesia team. |
| first_indexed | 2024-03-12T00:30:06Z |
| format | Article |
| id | doaj.art-5a022148114e41719d543f0374842165 |
| institution | Directory Open Access Journal |
| issn | 0894-1939 1521-0553 |
| language | English |
| last_indexed | 2024-03-12T00:30:06Z |
| publishDate | 2022-02-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Investigative Surgery |
| spelling | doaj.art-5a022148114e41719d543f03748421652023-09-15T10:21:28ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532022-02-0135362763110.1080/08941939.2021.19147851914785Hemodynamic Instability during Thyroidectomy in Graves’ DiseaseSami Acar0Candas Ercetin1Nuri Alper Sahbaz2Fırat Tutal3Yunus Yapalak4Fulya Cosan5Yesim Erbil6Department of General Surgery, Zeynep Kamil Women and Children’s Diseases Training and Research Hospital, University of Health SciencesDepartment of General Surgery, Bagcilar Training and Research Hospital, University of Health SciencesDepartment of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health SciencesDepartment of General Surgery, Istanbul Kolan HospitalDepartment of General Surgery, Bezmialem Vakif University Faculty of MedicineDepartment of Anesthesia and Reanimation, Acibadem Taksim HospitalDepartment of General Surgery, Istanbul Medical Faculty, University of IstanbulBackground The aim of this study was to investigate the changes in vital signs and hemodynamic status that occur in patients during the intraoperative course of thyroidectomy in Graves’ Disease (GD). Methods A total of 71 patients were included in the study. Patients were directed to surgery when they had large goiters with compressive symptoms or suspicious nodules, were pregnant or lactating, were unresponsive or intolerant to antithyroid drugs (ATDs), or expressed a preference to have surgery. All patients scheduled for operations underwent surgery while in the euthyroid state. Results Hemodynamic instability was observed in 18 patients during thyroidectomy. Disease duration, sample weight, and thyroid-stimulating hormone receptor antibodies (TRAb) levels were found to be effective on hemodynamic instability. Logistic regression analysis revealed an 11-fold increase in the instability risk in patients with a period of disease shorter than 21 months (P = 0.037). A TRAb value >11.5 increased the risk by 235fold (p < 0.001). Conclusion High levels of TRAb values and new onset of disease with shorter periods of ATDs use may be risk factors for hemodynamic instability during thyroidectomy. Patients with larger thyroid glands are at greater risk for instability during surgery. Those risks should be taken into account during surgery, and the surgical and anesthetic management of the patient should be made more carefully in concordance with the anesthesia team.http://dx.doi.org/10.1080/08941939.2021.1914785graves diseasehyperthyroidismthyrotropinhemodynamicsthyroidectomyantithyroid agents |
| spellingShingle | Sami Acar Candas Ercetin Nuri Alper Sahbaz Fırat Tutal Yunus Yapalak Fulya Cosan Yesim Erbil Hemodynamic Instability during Thyroidectomy in Graves’ Disease Journal of Investigative Surgery graves disease hyperthyroidism thyrotropin hemodynamics thyroidectomy antithyroid agents |
| title | Hemodynamic Instability during Thyroidectomy in Graves’ Disease |
| title_full | Hemodynamic Instability during Thyroidectomy in Graves’ Disease |
| title_fullStr | Hemodynamic Instability during Thyroidectomy in Graves’ Disease |
| title_full_unstemmed | Hemodynamic Instability during Thyroidectomy in Graves’ Disease |
| title_short | Hemodynamic Instability during Thyroidectomy in Graves’ Disease |
| title_sort | hemodynamic instability during thyroidectomy in graves disease |
| topic | graves disease hyperthyroidism thyrotropin hemodynamics thyroidectomy antithyroid agents |
| url | http://dx.doi.org/10.1080/08941939.2021.1914785 |
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