Thyroid Surgery Trends and Histopathological Patterns at a National Referral Center in Sri Lanka: A Retrospective Analysis (2017–2023)

Background: Thyroid disorders represent a significant spectrum of endocrine diseases globally. This study aimed to evaluate demographic, surgical, and histopathological trends of thyroidectomies at the National Hospital of Sri Lanka (NHSL) from 2017 to 2023.
Methods: This retrospective cohort study analyzed 2,580 thyroidectomy cases performed at NHSL between January 2017 and December 2023. Data were extracted from electronic and paper-based patient records, including demographic characteristics, surgical procedures, and histopathological findings. Statistical analysis was performed using chi-square tests and regression analysis.
Results: The cohort comprised 2,580 patients (84.7% female, mean age 47.7 years). Total thyroidectomy was the most common procedure (82.0%). Malignancy was identified in 24.5% of cases, with papillary carcinoma (18.2%) being the most common. Male gender was significantly associated with malignancy (32.6% vs 23.0%, p<0.001). Parathyroid glands were identified in 7.0% of specimens, and lymph nodes in 11.9% overall (29.3% in malignant cases).
Conclusion: This study represents the largest single-center audit of thyroid surgery in Sri Lanka. The findings highlight the predominance of benign disease, the significant association of male gender with malignancy, and opportunities for improving surgical quality indicators including parathyroid preservation and lymph node assessment.