ANALYSIS OF CLINICAL FEATURES INFLUENCING EMERGENCY THYROID SURGERY OUTCOMES IN ATHLETES

Abstract

Objective: To examine the clinical features and outcomes of emergency thyroid surgery in athletes, focusing on how these factors influence treatment efficacy and prognosis. Methods: This retrospective study analyzed 51 cases of emergency thyroid surgeries performed from May 2008 to June 2022, involving 20 male and 31 female athletes aged between 24 to 82 years. The primary indication for these surgeries was severe dyspnea, with conditions leading to surgery including 21 cases of nodular goiter and 30 cases of thyroid malignancy, of which two had undergone tracheal stenting prior to surgery. Results: All patients required general anesthesia with endotracheal intubation; one received extracorporeal membrane oxygenation (ECMO), and four underwent cardiopulmonary bypass. Surgical procedures varied based on the underlying pathology: 21 nodular goiters were treated with proximal thyroidectomy, while 25 malignant tumors necessitated total thyroidectomy. Complex surgeries included tracheal resections with end-to-end anastomosis and tracheotomy, and extensive resections involving laryngectomy and lymph node dissection. Postoperative outcomes were favorable with no occurrences of hemorrhage, recurrent laryngeal nerve damage, or parathyroid injury. Follow-ups ranging from 4 to 100 months showed that while 7 patients succumbed to tumor progression or related complications, the majority survived with improved respiratory function. Conclusions: Emergency thyroid surgeries in athletes, primarily necessitated by acute respiratory distress due to underlying thyroid conditions, are crucial for immediate symptom relief and potentially curative in certain cases. The high risk associated with delayed intervention underscores the importance of prompt, decisive surgical action to alleviate life-threatening obstructions and improve long-term survival outcomes. These findings advocate for rigorous monitoring and readiness to perform emergent surgical interventions in athletes presenting with thyroid-induced respiratory complications.