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Completion thyroidectomy: a critical appraisal.

A R Shaha1, B M Jaffe

  • 1Department of Surgery, State University of New York-Health Science Center, Brooklyn 11203.

Surgery
|December 1, 1992
PubMed
Summary
This summary is machine-generated.

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Completion thyroidectomy, reexploration to remove the other thyroid lobe, should be avoided due to increased risks. Specific indications are rare, and decisions should prioritize the initial surgery based on comprehensive findings.

Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Head and Neck Surgery

Background:

  • Completion thyroidectomy involves re-operating to remove the contralateral thyroid lobe, often after initial surgery for thyroid cancer.
  • This procedure carries a higher risk of complications and its routine use should be avoided.
  • Defining specific indications for completion thyroidectomy is crucial for patient management.

Observation:

  • A review of 400 thyroidectomies over 9 years found only three patients underwent completion thyroidectomy.
  • These three patients were referred after initial surgery and had aggressive follicular carcinoma requiring further treatment.
  • The authors have not performed completion thyroidectomy on patients during their initial surgery.

Findings:

  • The most common reason for considering completion thyroidectomy is a change in pathology from benign to malignant (follicular carcinoma) after initial surgery.

Related Experiment Videos

  • However, survival rates are similar even with minimal invasion, regardless of the extent of thyroidectomy.
  • Local recurrence in the contralateral lobe occurs in less than 10% of cases.

    • Implications:

    • Completion thyroidectomy should be avoided in most patients due to its associated risks.
    • The decision regarding the extent of thyroidectomy should be made during the initial operation, considering gross findings, prognostic factors, and frozen section results.
    • Completion thyroidectomy is reserved for select circumstances where clearly indicated.