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Total thyroidectomy vs completion thyroidectomy for thyroid nodules with indeterminate cytology/follicular
Giuseppe Sena1, Gaetano Gallo2, Nadia Innaro2
1Department of Health Sciences, U.O. of Digestive Surgery, University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy. gspp.sena@gmail.com.
BMC Surgery
|July 12, 2019
Summary
Completion thyroidectomy (CT) after hemithyroidectomy has similar complication rates to primary total thyroidectomy (TT) for indeterminate thyroid nodules. This suggests CT is a safe option for managing malignancy in these cases.
Area of Science:
- Endocrinology
- Surgical Oncology
- Thyroid Surgery
Background:
- Total thyroidectomy (TT) is standard for neoplastic lesions.
- Completion thyroidectomy (CT) after hemithyroidectomy is often performed for malignancy in indeterminate cytology cases.
- CT may carry higher complication risks than primary TT.
Purpose of the Study:
- To compare the morbidity rates of CT versus primary TT.
- To evaluate surgical outcomes in patients with indeterminate thyroid cytology.
Main Methods:
- Retrospective review of 237 thyroid surgery patients (2009-2018).
- Included patients with indeterminate cytology; excluded lymphadenectomies and benign pathologies.
- Compared 186 TT patients with 51 CT patients diagnosed with differentiated thyroid cancer.
Main Results:
- No significant difference in total complication rates between CT and TT groups (P=0.49).
- Subgroup analysis showed no significant differences in transient/permanent hypocalcemia, recurrent laryngeal nerve palsy, or hematoma.
- Specific complication rates (ORs and P-values) were not statistically significant between the groups.
Conclusions:
- Completion thyroidectomy (CT) following hemithyroidectomy is associated with acceptable morbidity.
- CT is a viable surgical option for patients with indeterminate thyroid cytology/follicular proliferation diagnosed with malignancy.
- The study supports the safety of CT in specific thyroid cancer management scenarios.
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