Thyroidectomy rates lower after guideline implementation

(HealthDay)—Implementation of the 2015 American Thyroid Association guidelines on surgery for well-differentiated thyroid carcinoma was associated with a significant decrease in the rates of both up-front total thyroidectomy and completion thyroidectomy, according to a study published online March 29 in JAMA Otolaryngology-Head & Neck Surgery.

Nir Hirshoren, M.D., from the Hadassah-Hebrew University Medical Center in Jerusalem, and colleagues performed a retrospective cohort study of 169 patients to evaluate clinical practice changes associated with implementation of the updated guidelines on the surgical procedure rates of total thyroidectomy, thyroid lobectomy, and completion thyroidectomy at a single tertiary medical center.

The researchers found that up-front total thyroidectomy was performed in 61 percent of patients before the 2015 American Thyroid Association guidelines were implemented and in 31.4 percent after guideline implementation (odds ratio [OR], 0.29). There was also a significant decrease in the rate of completion thyroidectomy between these periods (73.9 versus 20 percent; OR, 0.09).

"The extent of thyroidectomy was reduced considerably following the 2015 American Thyroid Association guidelines, and only one of five patients who undergo thyroid lobectomy will require a completion procedure according to the new criteria," the authors write.

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