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Applying an eMASS Customization Program as a Research Tool to Evaluate Consumer Benefits

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Published on: September 27, 2019

Does hemithyroidectomy still provide any benefit?

Marine Sarfati-Lebreton¹, Laurence Toqué¹, Jean-Baptiste Philippe¹

¹Service de chirurgie viscérale et endocrinienne, CHU d'Angers, 4, rue Larrey, 49100 Angers, France.

Annales D'Endocrinologie

|December 26, 2018

Summary

Hemithyroidectomy for multinodular goiter does not eliminate hormone replacement needs and carries a risk of completion surgery. However, it does reduce the rate of hypocalcemia compared to total thyroidectomy.

Keywords:

Completion thyroidectomy Complications Hemithyroidectomy Hormone replacement Isthmolobectomie Supplémentation hormonale Thyroïdectomie totale Total thyroidectomy Totalisation

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Area of Science:

Endocrinology
Surgical Oncology
Thyroid Surgery

Background:

Multinodular goiter affects 5% of the population.
Hemithyroidectomy is an alternative to total thyroidectomy to minimize risks and avoid hormone replacement.
Completion thyroidectomy may be required after hemithyroidectomy.

Purpose of the Study:

To evaluate the benefits of hemithyroidectomy versus total thyroidectomy for multinodular goiter.
To determine if hemithyroidectomy avoids hormone replacement therapy and its associated risks.
To assess the rate of completion thyroidectomy after hemithyroidectomy.

Main Methods:

Retrospective observational study of patients undergoing thyroid surgery (September 2010 - September 2014).
Analysis of hormone replacement rates at 6 months post-hemithyroidectomy.
Comparison of postoperative complications, including hypocalcemia, nerve palsy, hematoma, and completion thyroidectomy rates.

Main Results:

84.4% of hemithyroidectomy patients required hormone replacement.
Hemithyroidectomy showed a significantly lower rate of definitive hypocalcemia (0% vs 6.3%).
11.3% of hemithyroidectomies necessitated completion surgery due to carcinoma discovery.

Conclusions:

Hemithyroidectomy does not consistently avoid hormone replacement and increases the risk of completion thyroidectomy.
Hemithyroidectomy offers a benefit by avoiding hypocalcemia.
Consider hemithyroidectomy for single toxic/euthyroid nodules or patient refusal of hormone replacement.