Skip to main content
Top
Published in: Indian Journal of Surgery 6/2021

01-12-2021 | Goiter | Original Article

Thyroid autotransplantation after total thyroidectomy in multi-nodular goiter—a case series analysis

Authors: Sherif Monib, Hany Habashy, Mohamed Ibrahim

Published in: Indian Journal of Surgery | Issue 6/2021

Login to get access

Abstract

Background

Following the success of parathyroid autotransplantation, thyroid autotransplantation was introduced, aiming to avoid or reduce the severity of post-thyroidectomy hypothyroidism in noncompliant patients.

Aim

While our primary aim was to assess the survival and function of heterotopic autotransplanted thyroid tissue after total thyroidectomy, our secondary aim was to establish a relationship between autotransplanted volume and euthyroid state.

Methods

We conducted a case series analysis, including 40 women diagnosed with multinodular goiter for whom total thyroidectomy was considered. Patients were randomized into two groups: group A (20 patients) who received 15 g and group B (20 patients) who received 10 g of healthy non-nodular thyroid tissue.
Survival and function of heterotopic autotransplanted thyroid tissue was assessed by hormonal profile and thigh ultrasound scan (site of autotransplanted thyroid graft) 2, 6, and 12 months postoperatively.

Results

We have included 40 ladies divided into two groups: group A < 50 years and group B > 50 years. There was no statistically significant difference between group A and group B regarding radioactive iodine uptake after the 2nd, 6th, and 12th months. There was a statistically significant difference between results after the 2nd, 6th, and 12th months regarding free T3 (FT3; tri-iodothyronine), free T4 (FT4; thyroxine), thyroid-stimulating hormone, and pulse (p ≤ 0.001). The study revealed a highly statistically significant difference between the 2nd, 6th, and 12th months in FT3, FT4, and TSH levels and pulse (p ≤ 0.001) as well as highly statistically significant difference between group A and group B regarding FT3 and FT4 after the 2nd, 6th, and 12th months (p ≤ 0.001) (Tables 2 and 3).
Autotransplanted thyroid tissue processing and injection time range was 18–20 min, and none of the patients had immediate or delayed complications.

Conclusion

We found the procedure to be safe, successful, and not time-consuming; we also found that better results were achieved when larger volumes were implanted in younger patients.
Literature
1.
go back to reference Makay Ö (2017) Less than total thyroidectomy for goiter: when and how? Gland Surg 6(Suppl 1):S49–S58CrossRef Makay Ö (2017) Less than total thyroidectomy for goiter: when and how? Gland Surg 6(Suppl 1):S49–S58CrossRef
2.
go back to reference Hannoush ZC, Weiss RE (2016) Thyroid hormone replacement in patients following thyroidectomy for thyroid cancer. Rambam Maimonides Med J 7(1) Hannoush ZC, Weiss RE (2016) Thyroid hormone replacement in patients following thyroidectomy for thyroid cancer. Rambam Maimonides Med J 7(1)
3.
go back to reference Yüce İ, Okuducu H, Çağlı S, Vural A, Gündoğdu R, Abdülrezzak Ü, Arlı T, Aydın M, Güney E (2015) Experimental autotransplantation and cryopreservation of the thyroid gland. Head Neck 37(7):940–945CrossRef Yüce İ, Okuducu H, Çağlı S, Vural A, Gündoğdu R, Abdülrezzak Ü, Arlı T, Aydın M, Güney E (2015) Experimental autotransplantation and cryopreservation of the thyroid gland. Head Neck 37(7):940–945CrossRef
4.
go back to reference Papaziogas B, Antoniadis A, Lazaridis C, Makris J, Kotakidou R, Paraskevas G, Papaziogas T (2002) Functional capacity of the thyroid autograft: an experimental study. J Surg Res 103(2):223–227CrossRef Papaziogas B, Antoniadis A, Lazaridis C, Makris J, Kotakidou R, Paraskevas G, Papaziogas T (2002) Functional capacity of the thyroid autograft: an experimental study. J Surg Res 103(2):223–227CrossRef
5.
go back to reference Mohsen AA, Nada AA, Ibrahim MY, Ghaleb AH, Abou-Gabal MA, Mohsen AA, Wassef AT (2017) Technique and outcome of autotransplanting thyroid tissue after total thyroidectomy for simple multinodular goiters. Asian J Surg 40(1):17–22CrossRef Mohsen AA, Nada AA, Ibrahim MY, Ghaleb AH, Abou-Gabal MA, Mohsen AA, Wassef AT (2017) Technique and outcome of autotransplanting thyroid tissue after total thyroidectomy for simple multinodular goiters. Asian J Surg 40(1):17–22CrossRef
6.
go back to reference Jonklaas J, Bianco AC, Bauer AJ, Burman KD, Cappola AR, Celi FS, Cooper DS, Kim BW, Peeters RP, Rosenthal MS, Sawka AM (2014) Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association task force on thyroid hormone replacement. Thyroid. 24(12):1670–1751CrossRef Jonklaas J, Bianco AC, Bauer AJ, Burman KD, Cappola AR, Celi FS, Cooper DS, Kim BW, Peeters RP, Rosenthal MS, Sawka AM (2014) Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association task force on thyroid hormone replacement. Thyroid. 24(12):1670–1751CrossRef
7.
go back to reference Shimizu K, Kumita SI, Kitamura Y, Nagahama M, Kitagawa W, Akasu H, Oshina T, Kumasaki T, Tanaka S (2002) Trial of autotransplantation of cryopreserved thyroid tissue for postoperative hypothyroidism in patients with Graves’ disease. J Am Coll Surg 194(1):14–22CrossRef Shimizu K, Kumita SI, Kitamura Y, Nagahama M, Kitagawa W, Akasu H, Oshina T, Kumasaki T, Tanaka S (2002) Trial of autotransplantation of cryopreserved thyroid tissue for postoperative hypothyroidism in patients with Graves’ disease. J Am Coll Surg 194(1):14–22CrossRef
9.
go back to reference Wartofsky L (2002) Levothyroxine: therapeutic use and regulatory issues related to bioequivalence. Expert Opin Pharmacother 3(6):727–732CrossRef Wartofsky L (2002) Levothyroxine: therapeutic use and regulatory issues related to bioequivalence. Expert Opin Pharmacother 3(6):727–732CrossRef
10.
go back to reference Dobrinja C, Trevisan R, Trevisan G, Liguori G (2008) Autotransplantation of thyroid tissue in rats: an experimental study. Ann Ital Chir 79(5):389–395PubMed Dobrinja C, Trevisan R, Trevisan G, Liguori G (2008) Autotransplantation of thyroid tissue in rats: an experimental study. Ann Ital Chir 79(5):389–395PubMed
11.
go back to reference Leoncini E, Ricciardi W, Cadoni G, Arzani D, Petrelli L, Paludetti G, Brennan P, Luce D, Stucker I, Matsuo K, Talamini R (2014) Adult height and head and neck cancer: a pooled analysis within the INHANCE Consortium. Eur J Epidemiol 29(1):35–48CrossRef Leoncini E, Ricciardi W, Cadoni G, Arzani D, Petrelli L, Paludetti G, Brennan P, Luce D, Stucker I, Matsuo K, Talamini R (2014) Adult height and head and neck cancer: a pooled analysis within the INHANCE Consortium. Eur J Epidemiol 29(1):35–48CrossRef
12.
go back to reference Sakr M, Mahmoud A (2017) Review of heterotopic thyroid autotransplantation. Clin Exp Otorhinolaryngol 10(4):289–295CrossRef Sakr M, Mahmoud A (2017) Review of heterotopic thyroid autotransplantation. Clin Exp Otorhinolaryngol 10(4):289–295CrossRef
13.
go back to reference Yousef M, Sulieman A, Ahmed B, Abdella A, Eltom K (2011) Local reference ranges of thyroid volume in Sudanese normal subjects using ultrasound. J Thyroid Res:2011 Yousef M, Sulieman A, Ahmed B, Abdella A, Eltom K (2011) Local reference ranges of thyroid volume in Sudanese normal subjects using ultrasound. J Thyroid Res:2011
14.
go back to reference Adibi A, Sirous M, Aminorroaya A et al (2008) Normal values of thyroid gland in Isfahan, an iodine replete area. J Res Med Sci 13:55e60 Adibi A, Sirous M, Aminorroaya A et al (2008) Normal values of thyroid gland in Isfahan, an iodine replete area. J Res Med Sci 13:55e60
15.
go back to reference Shimizu K, Kitamura Y, Nagahama M, Shoji T (1991) A fundamental study of the thyroid transplantation for the patient with irreversible hypothyroidism (the first report: an autotransplantation of cryopreserved thyroid): preliminary report. Nihon Geka Gakkai Zasshi 92(12):1728PubMed Shimizu K, Kitamura Y, Nagahama M, Shoji T (1991) A fundamental study of the thyroid transplantation for the patient with irreversible hypothyroidism (the first report: an autotransplantation of cryopreserved thyroid): preliminary report. Nihon Geka Gakkai Zasshi 92(12):1728PubMed
16.
go back to reference Banu SK, Arosh JA, Govindarajulu P, Aruldhas MM (2001) Testosterone and estradiol differentially regulate thyroid growth in Wistar rats from immature to adult age. Endocr Res 27(4):447–463CrossRef Banu SK, Arosh JA, Govindarajulu P, Aruldhas MM (2001) Testosterone and estradiol differentially regulate thyroid growth in Wistar rats from immature to adult age. Endocr Res 27(4):447–463CrossRef
17.
go back to reference El Hadad LH, Mohsen AA, El Sanadeky MN, Mahran K (2020) Assessment of survival and function of heterotopic autotransplanted thyroid tissue after total thyroidectomy for non-toxic multinodular goiters. Indian J Public Health Res Dev 11(2):1641–1645CrossRef El Hadad LH, Mohsen AA, El Sanadeky MN, Mahran K (2020) Assessment of survival and function of heterotopic autotransplanted thyroid tissue after total thyroidectomy for non-toxic multinodular goiters. Indian J Public Health Res Dev 11(2):1641–1645CrossRef
18.
go back to reference Gamal AM, Elnaga NE, Ayoub MT, Farghally AR (2019) Thyroid autotransplantation following total thyroidectomy in benign thyroid disorders: a new technique to avoid postoperative hypothyroidism. Int Surg J 6(7):2267–2271CrossRef Gamal AM, Elnaga NE, Ayoub MT, Farghally AR (2019) Thyroid autotransplantation following total thyroidectomy in benign thyroid disorders: a new technique to avoid postoperative hypothyroidism. Int Surg J 6(7):2267–2271CrossRef
Metadata
Title
Thyroid autotransplantation after total thyroidectomy in multi-nodular goiter—a case series analysis
Authors
Sherif Monib
Hany Habashy
Mohamed Ibrahim
Publication date
01-12-2021
Publisher
Springer India
Published in
Indian Journal of Surgery / Issue 6/2021
Print ISSN: 0972-2068
Electronic ISSN: 0973-9793
DOI
https://doi.org/10.1007/s12262-021-02719-z

Other articles of this Issue 6/2021

Indian Journal of Surgery 6/2021 Go to the issue