Endocrine Abstracts

Introduction: The availability of an increasing therapeutic arsenal for endocrine diseases seems to explain the current trend towards a decrease in the indications of endocrine surgery. However, this trend requires a detailed study before being confirmed in our setting.

Objectives: We aimed to assess the trends in the performance of endocrine surgery, in children and adults, during three consecutive years (2014, 2015 and 2016) in our University Tertiary-Care Referral Hospital, settled in Madrid (Spain).

Methods: We contacted the Pathology Service and the main surgical Services involved, collected the number of thyroidectomies, parathyroidectomies, adrenalectomies and surgeries in the hypothalamic-pituitary area per year in the period of study, and calculated the corresponding interannual and overall variation rates.

Results: The number of thyroidectomies, parathyroidectomies, adrenalectomies and surgeries of lesions in the hypothalamic-pituitary area performed per year were 264, 57, 30 and 43, respectively, for 2014; 259, 63, 22 and 39 for 2015; and 260, 52, 15 and 17 for 2016. The number of surgeries of the hypothalamic-pituitary area in children were 8, 9 and 7, in 2014, 2015 and 2016, respectively, whereas in adults were 35, 30 and 10. This means an overall decrease in the number of surgeries in the hypothalamic-pituitary area of 60.5% between 2014 and 2016, due, almost entirely, to the reduction of surgeries in adults (71.4%), and a global decrement of 50% in the number of adrenalectomies, while the number of thyroidectomies and parathyroidectomies remained stable during the study period, showing small interannual variation rates and annual averages of 261 and 57, respectively.

Conclusions: There is a strong and consisting trend towards a decrease in the number of surgeries in the hypothalamic-pituitary area (particularly in adults) and adrenalectomies during the last 3 years, while the number of thyroidectomies and parathyroidectomies has remained stable in the same period of time in our Tertiary-Care Referral Hospital. Further studies are required to evaluate the presence of similar trends in other medical centers of the rest of Spain and Europe, and, in case they are confirmed, analyze their causes as well as the potential associated economic impact in the medium and long-term.