title: Surgery in Hashimoto's thyroiditis: indications, complications, and associated cancers.
abstract: BACKGROUND
  Indications for surgery in Hashimoto's thyroiditis (HT) patients are compressive symptoms and suspicion of malignancy. A high incidence of thyroid malignancy has been reported in patients with HT. The effect of surgery on discomfort in swallowing and tightness in the neck has not been properly evaluated.
  
  
  OBJECTIVE
  The aim of our study is to compare the indications, complications, and associated cancers in patients operated for HT with those surgically treated for other benign goitres. The effect of surgery on minor symptoms like tightness in the neck and discomfort in swallowing is included.
  
  
  METHODS
  This was a retrospective case-control study at a tertiary care centre.
  
  
  METHODS
  A total of 271 patients who had undergone surgery for benign thyroid diseases were included. Group A consisted of 35 patients who had HT and Group B consisted of patients operated for other benign thyroid diseases (236 patients).
  
  
  METHODS
  Data were analyzed using SPSS 12 software. Independent group's t-test was used to compare the means and Fisher's exact test was used for categorical data.
  
  
  RESULTS
  In Group A, the common indications for surgery were discomfort associated with swelling (45.7%), cosmesis (34.3%), and pain with swelling (11.4%) whereas in Group B, the indication was predominantly cosmetic (80%). A total of 22.9% patients of Group A and 6% of Group B were hyperthyroid. The sensitivity of FNAC for diagnosing thyroiditis was 62.8% (n = 22). Postoperative complication rates were similar in both the groups. The mean operating time was higher in Group A even though the gland was smaller. Incidental malignancy was 3.4% in Group B whereas there was none in Group A. Discomfort in swallowing and tightness in the neck were relieved at 3 months after surgery.
  
  
  CONCLUSIONS
  Large, euthyroid and apparently asymptomatic HT occasionally need surgical intervention. Discomfort in swallowing and tightness in the neck are relieved after surgery. Thyroidectomy is safe to perform and has a low incidence of permanent complications. There was no associated malignancy in our series of HT.
authors.affiliation: Department of Endocrine Surgery, Narayana Medical College & Superspeciality Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India. pradeepputhenveetil@yahoo.co.in
authors.forename: P V
authors.initials: PV
authors.lastname: Pradeep
authors.forename: M
authors.initials: M
authors.lastname: Ragavan
authors.forename: B A
authors.initials: BA
authors.lastname: Ramakrishna
authors.forename: B
authors.initials: B
authors.lastname: Jayasree
authors.forename: S H
authors.initials: SH
authors.lastname: Skandha
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D050031:Hashimoto Disease / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000150:complications; D013965:Thyroidectomy