Maqbool Ahmad, Mumtaz Ahmad, Zakaullah Malik, SA Janjua.
Surgical Audit of Solitary Thyroid Nodule.
Pak Armed Forces Med J Jan ;51(2):106-10.

Between January 1997 to January 2000, 113 patients underwent thyroidectomy for solitary thyroid nodules in Department of Surgery Combined Military Hospital Kharian. Majority of patients belonged to Azad Kashmir, District Gujrat and Jehlum. Patients age ranged from 13 to 70 years, with 88 females (77.8%) and 25 males (22.1%). Thyroid scan was carried out in 90 cases and ultrasound examination was done in 7 cases. Fine needle aspiration cytology (FNAC) was done in 94 cases preoperatively. Near total or total lobectomy and Isthmectomy was done in 84 cases and 18 cases underwent nodulectomy. Isthmectomy was done in 7 cases for nodules located in the isthmus. 4 cases underwent total thyroidectomy. Postoperatively there was slight hoarseness of voice in 4 cases and there was no case of postoperative haemorrhage or mortality. Malignancy was seen in only 5 cases (4.4%). It was seen both in cold (4.6%) as well as in warm (4.4%) nodules. In this hospital based study the incidence of malignancy was less (4.4%) in solitary thyroid nodule compared with international figure of 4.7-18.3% and majority are undergoing operation for what is subsequently shown to be benign thyroid disease. These patients can be safely observed without operation after fine needle aspiration cytology has declared it benign. The information p[provided by thyroid scan has less bearing in the management. Fine needle aspiration cytology (FNAC) provides useful information and may be used along with other clinical information to decide best form of treatment in a solitary thyroid nodule.

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