Surgical Indications in Hashimoto’s Thyroiditis:  A Retrospective Study from Tobruk Medical Center

• Faraj Aljali

  General Surgery Department, Faculty of Medicine, Tobruk University, Tobruk, Libya

  Author

• Fathi Asnini

  General Surgery Department, Faculty of Medicine, Tobruk University, Tobruk, Libya

  Author

Hashimoto’s thyroiditis (HT) is the most common cause of hypothyroidism and an autoimmune disorder characterized by chronic inflammation of the thyroid gland. While most patients are managed medically, a subset requires surgical intervention. This study was conducted to identify the clinical, laboratory, and radiological indications for surgery in patients with Hashimoto’s thyroiditis. A retrospective analysis of 63 patients diagnosed with HT between January 2010 and December 2021 at Tobruk Medical Center. Data included clinical presentation, thyroid function tests (T3, T4, TSH), autoantibodies (Anti-TPO, Anti-TG), ultrasound findings, and fine needle aspiration cytology (FNAC). Statistical analysis was performed using the Chi-square test (SPSS 23). Of 63 patients, 51 (80.9%) were treated medically and 12 (19.1%) surgically. Significant associations with surgical treatment were found for age <40 years (p<0.05), female sex (p<0.05), positive family history (p<0.05), diagnostic ultrasound findings (p<0.05), and informative FNAC (p<0.05). Hypothyroidism was present in 57.2%, euthyroidism in 39.6%, and hyperthyroidism in 3.2%. All patients were Anti-TPO positive, and 58.7% were Anti-TG positive. Surgery for Hashimoto’s thyroiditis is indicated in patients with compressive goiter, persistent high autoantibody levels despite medical therapy, or thyroid nodules with suspected or confirmed malignancy.

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