THYROID-PARATHYROID SURGERY DURING CORONAVIRUS PANDEMIC
Thyroidectomy-parathyroidectomy: strict indications during coronavirus pandemic.-In the vast majority of patients, thyroidectomy – parathyroidectomy can be postponed during the coronavirus pandemic. Thus, surgery can be performed safely at a second time, without risk for the patients.
The risk of COVID-19 infection is very high and real, especially for the high-risk group of patients (aged patients, patients with coexisting diseases etc.).
Adverse outcome cannot be predicted, however, even for younger patients with COVID-19 infection, without underlying diseases.
For these reasons, indications for thyroid-parathyroid surgery during coronavirus pandemic should be strict and include:
• Life-threatening or severely symptomatic thyrotoxicosis in patients with Graves’ disease, that cannot be controlled medically
• Extensive enlargement of the thyroid gland in patients with goiter or very large thyroid nodules, causing compression symptoms, mainly from the tracheal (dyspnea). However, this is not an acute presentation, since the enlargement is progressive over many months or years.
• Patients with aggressive thyroid cancer, that are imminently threatening the life or the health of the patient such as those with short double timings or aggressive recurrences.
• Open biopsy to confirm a suspected diagnosis of anaplastic thyroid cancer or thyroid lymphoma in order to direct appropriate treatment.
Hyperparathyroidism with severe, life-threatening hypercalcemia (> 14 mg/dl), that cannot be controlled medically