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German Association of Endocrine Surgeons practice guidelines for the surgical treatment of benign thyroid disease
Authors:Thomas J. Musholt  Thomas Clerici  Henning Dralle  Andreja Frilling  Peter E. Goretzki  Michael M. Hermann  Jochen Ku?mann  Kerstin Lorenz  Christoph Nies  Jochen Schabram  Peter Schabram  Christian Scheuba  Dietmar Simon  Thomas Steinm��ller  Arnold W. Trupka  Robert A. Wahl  Andreas Zielke  Andreas Bockisch  Wolfram Karges  Markus Luster  Kurt W. Schmid
Affiliation:1. Section of Endocrine Surgery, Clinic of General and Abdominal Surgery, University Medical Center, Gutenberg University??Mainz, Langenbeckstr. 1, 55101, Mainz, Germany
2. Department of Surgery, Kantonsspital St. Gallen, CH-9007, St. Gallen, Switzerland
3. Department for General, Visceral and Vascular Surgery, Martin-Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany
4. Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, Du Cane Road, London, W12 0HS, UK
5. Surgical Department 1, Lukaskrankenhaus Neuss, Preussenstr. 84, 41456, Neuss, Germany
6. Department of Surgery, Kaiserin-Elisabeth-Spital, Medical University of Vienna, Huglgasse 1?C3, Vienna, Austria
7. Clinic for Endocrine Surgery, Sch?n Klinik Hamburg?CEilbek, Dehnhaide 120, 22081, Hamburg, Germany
8. Department for General and Visceral Surgery, Niels-Stensen-Kliniken, Marienhospital Osnabr??ck, Bischofsstr. 1, 49074, Osnabr??ck, Germany
9. Department of Surgery, St. Josefs Hospital, Liebigstr. 24, 35338, Giessen, Germany
10. Ratajczak & Partners??Solicitors??Berlin?Cologne?Essen?Freiburg?Meissen?Munich?Sindelfingen, Heinrich-von-Stephan-Str. 25, 79100, Freiburg, Germany
11. Division of General Surgery, Department of Surgery, Medical University, W?hringer G??rtel 18?C20, 1090, Vienna, Austria
12. Department of General and Visceral Surgery, Bethesda Hospital, Heerstrasse 219, 47053, Duisburg, Germany
13. Department of Visceral and Endocrine Surgery, DRK-Kliniken Berlin-Westend, Spandauer Damm 130, 14050, Berlin, Germany
14. Department of Surgery, Kreiskrankenhaus Starnberg GmbH O?waldstr. 1, 82319, Starnberg, Germany
15. Department of Endocrine Surgery, Burgerhospital Frankfurt am Main e.V, Nibelungenallee 37?C41, 60318, Frankfurt, Germany
16. Department of Surgery, Klinikum Offenbach GmbH, Starkenburgring 66, 63069, Offenbach, Germany
17. Department of Nuclear Medicine, University Hospital of Essen, Hufelandstr. 55, 45122, Essen, Germany
18. Division of Endocrinology and Diabetes, RWTH University Hospital Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany
19. Department of Nuclear Medicine, University of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
20. Department of Pathology, University Hospital of Essen, Hufelandstr. 55, 45122, Essen, Germany
Abstract:

Introduction

Benign thyroid disorders are among the most common diseases in Germany, affecting around 15 million people and leading to more than 100,000 thyroid surgeries per year. Since the first German guidelines for the surgical treatment of benign goiter were published in 1998, abundant new information has become available, significantly shifting surgical strategy towards more radical interventions. Additionally, minimally invasive techniques have been developed and gained wide usage. These circumstances demanded a revision of the guidelines.

Methods

Based on a review of relevant recent guidelines from other groups and additional literature, unpublished data, and clinical experience, the German Association of Endocrine Surgeons formulated new recommendations on the surgical treatment of benign thyroid diseases. These guidelines were developed through a formal expert consensus process and in collaboration with the German societies of Nuclear Medicine, Endocrinology, Pathology, and Phoniatrics & Pedaudiology as well as two patient organizations. Consensus was achieved through several moderated conferences of surgical experts and representatives of the collaborating medical societies and patient organizations.

Results

The revised guidelines for the surgical treatment of benign thyroid diseases include recommendations regarding the preoperative assessment necessary to determine when surgery is indicated. Recommendations regarding the extent of resection, surgical techniques, and perioperative management are also given in order to optimize patient outcomes.

Conclusions

Evidence-based recommendations for the surgical treatment of benign thyroid diseases have been created to aid the surgeon and to support optimal patient care, based on current knowledge. These recommendations comply with the Association of the Scientific Medical Societies in Germany requirements for S2k guidelines.
Keywords:
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