Clinico-Pathologic Profile of Patients who Underwent Thyroidectomy

in a Tertiary Private Institution: A 5-year Retrospective Study

A Research Paper Submitted to the Department of Surgery

University of Cebu Medical Center
Ouano St., Subangdaku, Mandaue City, Cebu

In Fulfillment of the Requirements for

Residency in General Surgery

Co-Author:

Leonil Dacaynos, MD

By:

Elvin Louie E. Lisondra, MD

Surgical Resident
 CHAPTER I
INTRODUCTION

Background of the Study

Conceptual Framework

Patients who underwent thyroidectomy at University of Cebu Medical Center from January 2017 to
December 2022

Chart Review (Medical Records)

Demographic Profile: Preoperative Diagnosis Type of Surgery Use of drain Complications Final histopathologic diagnosis

Total
Age Histopathology With Hypocalcemia
thyroidectomy

Hoarseness of
Sex TIRADS Lobectomy Without
voice

Lobectomy with Hematoma

Family History
Isthmusectomy formation

Completion
thyroidectomy

Significance of the Study

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 A description of the institution's experience in the management of thyroid diseases in
the form of thyroidectomy would contribute to existing literature. This study aims to describe
the clinicopathologic profile of patients who underwent thyroidectomy in a tertiary level private
institution. The information generated would elucidate patterns and trends in the surgical
management of thyroid problems.

Research Question

What are the clinic-pathologic profile of patients who underwent thyroidectomy at

University of Cebu Medical Center from January 2017 to December 2022.

General Objectives

To determine the clinic-pathologic profile of patients who underwent thyroidectomy at

University of Cebu Medical Center from January 2017 to December 2022.

Specific Objectives

1. To determine the profile of patients who underwent thyroidectomy in UCMED from

January 2017 to December 2022 as to:
a. Non-modifiable risk factors (Age, sex and family history)
2. To determine the preoperative diagnostic parameters utilized (Histopathology, TIRADS)
3. To determine the type of thyroidectomy the patients underwent and whether there was
use of drains
4. To identify cases who presented with postoperative complications (Hypocalcemia,
hoarseness of voice, hematoma formation)
5. To correlate final histopathologic results with the preceding variables

Operational Definition of Terms

 TIRADS – standardized radiologic scoring for thyroid lesions
 Preoperative histopathology – histopathologic results from fine needle aspiration prior
to thyroidectomy
 Drains – Penrose drains inserted to the surgical wound
 Hypocalcemia – laboratory finding of less than 2 mM/L (8.0 mg/dL) or an ionized calcium
level less than 1.1 mM/L (0.275 mg/dL) within the same admission as the thyroidectomy
 Hoarseness of voice – clinical change in the quality of voice described by the patient or
his/her accompanying as hoarseness of the voice

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 CHAPTER II

Review of Related Literature

Page 3 of 8
 CHAPTER III

Methodology
This will be a retrospective, descriptive cross-sectional study of patients who underwent
thyroidectomy at University of Cebu Medical Center. Patients’ charts will be retrieved from the
Medical Records Section and electronic patient registry files.

The following information will be obtained: age, sex, clinical presentation, preoperative
biopsy results, TIRADS scores, operation performed, perioperative course, and surgical
complications. This study will be limited by the completeness and accuracy of records obtained
from both registries and in-patient charts.

Research Design
A retrospective 5-year case series on patients who underwent thyroidectomy in
University of Cebu Medical Center from January 2017 to December 2022.

Research Population
Patients who underwent thyroidectomy in University of Cebu Medical Center from
January 2017 to December 2022

Inclusion Criteria
Patients who underwent thyroidectomy in University of Cebu Medical Center from
January 2017 to December 2022

Exclusion Criteria
Patients who underwent neck dissection after thyroidectomy.

Research Site
University of Cebu Medical Center, a tertiary, private hospital located at Ouano Street,
Subangdaku, Mandaue City, Cebu.

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Statistical Treatment
The research's general design classification would be quantitative since the variables in
the study are obtained from retrospective data. Based on the objectives of the study, the major
research design will be descriptive. The descriptive study approach is primarily concerned with
describing the characteristics of a demographic segment, in this example, patients who
underwent thyroidectomy.

To fulfill the set objectives, a univariate and multivariate analysis will be employed. The
analysis will be utilized to comprehend the distribution of values for each data set collected
from the population individually. It considers the range of values as well as their central
tendency, describes the pattern of response to the variable, and explains each variable
separately. The variables include non-modifiable factors (age, sex, and family history),
preoperative histopathology, TIRADS, type of thyroidectomy, use of drains and postoperative
complications (hypocalcemia, hoarseness of voice, hematoma formation).

The tools for univariate analysis will include frequency distribution, which considers the
frequency with which the value will occur in the data set. As numerical treatments, the mean,
median, mode, range, standard deviations, variance, and coefficient of variation will be used.
Charting will also be utilized to analyze data sets, establish distribution shape properties, and
locate extreme values.

The multivariate analysis is the observation of multiple variables and identify if there are
correlations between them. Variables in pre-operatives will be tested against post-operative
variables. Correlational coefficient and regression analysis will be employed as numerical
treatments in this kind.

Ethical Considerations
The data that will be collected from patients who underwent thyroidectomy at
University of Cebu Medical Center will be kept confidential all throughout the study. Only the
variables identified in the specific objectives will be included in the study. The names, contact
numbers will not be disclosed.

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Dummy Tables

Table 1.1: Non-modifiable Risk Factors

NON-MODIFIABLE RISK FACTORS NUMBER OF PATIENTS
AGE
10-20 years old
21-30 years old
31-40 years old
41-50 years old
51-60 years old
61-70 years old
SEX
Male
Female
FAMILY HISTORY OF MALIGNANCY
None
1st degree relative with thyroid malignancy
2nd degree relative with thyroid malignancy

Table 1.2: Preoperative Diagnosis

HISTOPATHOLOGIC DIAGNOSIS NUMBER OF PATIENTS

Table 1.3: TIRADS Score

TIRADS Score NUMBER OF PATIENTS
1
2
3
4
5
No preoperative imaging done

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Table 1.4: Type of Surgery
Type of Surgery NUMBER OF PATIENTS
Total thyroidectomy
Lobectomy
Lobectomy with isthmectomy
Completion thyroidectomy

Table 1.5: Postoperative Complications

Complications NUMBER OF PATIENTS
Hypocalcemia
Hematoma formation
Hoarseness of voice

Table 1.6: Use of Drain

Use of Drain NUMBER OF PATIENTS
With
Without

Table 1.7: Postoperative Histopathologic Result

Histopathology NUMBER OF PATIENTS

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