SURGICAL MANAGEMENT OF THYROID NODULES

Thyroid nodules are so common as to constitute a public health problem. The abundant literature on their diagnostic management reflects the absence of a consensus. Fine-needle aspiration biopsy (FNAB) is the gold-standard diagnostic investigation. The objective of this study was to describe the diagnosis and surgical treatment of nodular disease and cancer of the thyroid gland. This is a prospective study of 103 consecutive patients treated surgically for thyroid nodules at Regional Hospital, of Shkodra, Albania over the period 20110-2013. There were 26 (24.8%) males and 79 (75.2%) females, with a mean age of 47.4 years old with a range 18-78 years old). The female-to-male ratio was 3.0/1. The average age for men was 41.8 years old and 47.85 years old for females. The mean history period was 4.9 years and the mean duration of hospitalization was 8.2 days. The reason for surgery was presence of mechanical complications (12%), hyperthyroidism (15%), solitary nodules (52%) and suspected cancer (21%). FNA was done in 103 patients. Compared with histological findings, among patients with malignant cells or suspicious follicular or papillary cells by FNAB, 44.4% had cancer; among patients with normal FNAB findings, 13.8 % had cancer. This difference was highly significant (OR, 4.9; 95%CI, 1.8-4.1 p<0.01).Fine-needle aspiration biopsy are the best diagnostic tools for differentiating benign nodules from suspicious or malignant nodules.