title: Predictive factors for longer operative times for thyroidectomy.
abstract: OBJECTIVE
  Conventional open thyroidectomy is considered as a safe surgery nowadays. However, surgeons sometimes encounter unexpected difficulty when performing thyroidectomies. The aim of this paper was to identify the predictors of a difficult thyroidectomy for the management of patients with papillary thyroid carcinoma.
  
  
  METHODS
  A database of patients who underwent open conventional thyroidectomy with cervical lymph node dissection after diagnosed papillary thyroid carcinoma between July 2008 and June 2013 was examined. In addition, the patients were subgrouped by difficult thyroidectomy (DT) and nondifficult thyroidectomy to determine the predictors of DT according to operation time. Clinicopathologic characteristics, surgical outcomes, and postoperative morbidities were investigated.
  
  
  RESULTS
  No between-group differences in clinicopathologic factors and postoperative complications, except for male sex (p < 0.001) and tumor size (p = 0.039), were noted. Male sex [odds ratio (OR) 4.158, 95% confidence interval (CI) 2.020-8.559, p = 0.043] and age < 45 years (OR 2.239, 95% CI 1.304-3.843, p = 0.003) were independent factors associated with DT in a multivariate logistic regression model. Elevated antithyroglobulin antibody (OR 1.004, 95% CI 1.000-1.008, p = 0.030) was a variable which is statistically significant, but not clinically significant.
  
  
  CONCLUSIONS
  Young age and male sex might be regarded as predictors of DT. Expecting DT before surgery might help surgeons, especially beginners, prevent troublesome situations.
authors: Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea.
authors: Hee Yong
authors: HY
authors: Kwak
authors: 1st Division of Surgery, Department of Surgical Sciences, Endocrine Surgery Research Center, University of Insubria, Varese, Italy.
authors: Gianlorenzo
authors: G
authors: Dionigi
authors: Jilin Provincial Key Laboratory of Surgical Translational Medicine, Japan Union Hospital of Jilin University, Division of Thyroid Surgery, Changchun City, Jilin Province, China.
authors: Xiaoli
authors: X
authors: Liu
authors: Jilin Provincial Key Laboratory of Surgical Translational Medicine, Japan Union Hospital of Jilin University, Division of Thyroid Surgery, Changchun City, Jilin Province, China.
authors: Hui
authors: H
authors: Sun
authors: Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea.
authors: Sang Uk
authors: SU
authors: Woo
authors: Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea.
authors: Gil Soo
authors: GS
authors: Son
authors: Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea.
authors: Jae Bok
authors: JB
authors: Lee
authors: Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea.
authors: Jeoung Won
authors: JW
authors: Bae
authors: Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea. Electronic address: hoonyubkim@gmail.com.
authors: Hoon Yub
authors: HY
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D002681:China; D015331:Cohort Studies; D016001:Confidence Intervals; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D016017:Odds Ratio; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: antithyroglobulin antibody; difficulty; thyroidectomy