Thyroid function after unilateral total lobectomy: risk factors for postoperative hypothyroidism

Area of Science:

• Endocrinology
• Thyroid Surgery
• Oncology

Background:

• Unilateral total lobectomy is a common thyroid surgery.
• Postoperative hypothyroidism is a potential complication.
• Identifying risk factors is crucial for patient management.

Purpose of the Study:

• To determine the incidence of hypothyroidism after unilateral total lobectomy.
• To identify factors associated with postoperative hypothyroidism.

Main Methods:

• Retrospective analysis of 168 patients undergoing unilateral total lobectomy for benign diseases.
• Assessment of serum thyrotropin, antithyroidal antibodies, and thyroid remnant volume.
• Definition of hypothyroidism as thyrotropin level > 5.5 mU/L.

Main Results:

• Hypothyroidism occurred in 32.8% of patients over a median follow-up of 29 months.
• Risk factors included higher preoperative thyrotropin, smaller thyroid remnant volume, right-sided lobectomy, and elevated thyroperoxidase antibodies.
• Female patients constituted 88% of the study cohort.

Conclusions:

• Postoperative hypothyroidism is a significant concern after unilateral thyroid lobectomy.
• Elevated preoperative thyrotropin, smaller remnant volume, right lobectomy, and positive antithyroid antibodies are key predictors.
• Consideration for early hormone supplementation in high-risk patients is warranted.