Is timing important in thyroid reoperation?

Although it is recommended to perform completion thyroidectomy as soon as possible after the initial operation, there are no consensus guidelines about the appropriate time interval for the reoperation. The aim of the present study was to compare the postoperative complications, the amount of residual tissue, and postoperative thyroid-stimulating hormone (TSH) and thyroglobulin (Tg) levels following completion thyroidectomy that was performed at different time intervals.

Sixty patients who had already undergone bilateral subtotal thyroidectomy for benign colloidal goitre and who were then diagnosed as having thyroid carcinomas at histopathologic examination were included in the study. Twenty-nine patients had completion thyroidectomy within 90 days of the initial operation (group 1). Thirty-one patients had completion thyroidectomy 90 days after the initial operation (group 2).

Tertiary clinic.

The incidence of transient recurrent laryngeal nerve palsy did not show any significant difference between the groups. The incidence of transient hypoparathyroidism was significantly high in group 1 (p < .001). The number of parathyroid glands identified during completion thyroidectomy in group 1 was lower than in group 2. In addition, it has been shown that more tissue can be excised in group 2 patients in comparison with group 1 patients, as demonstrated by comparing the reduction in the thyroid volume and the levels of TSH and Tg between the two groups.

If it is not possible to perform completion thyroidectomy within the first week of the initial operation, completion thyroidectomy 90 days after the initial operation is beneficial to reduce the incidence of complications and makes more thyroid tissue excision possible.