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Outcomes of Early Versus Delayed Completion Thyroidectomy for Malignancy.
Jaimie J Park1, Ethan Frank2, Alfred A Simental2
1Loma Linda University School of Medicine, Loma Linda, CA, USA.
The American Surgeon
|January 3, 2022
Summary
Performing completion thyroidectomy later after hemi-thyroidectomy increases hypocalcemia risk but lowers vocal and swallowing issues. Early completion thyroidectomy may expedite cancer treatment with similar safety.
Area of Science:
- Endocrinology
- Surgical Oncology
- Thyroid Surgery
Background:
- Completion thyroidectomy is a common procedure following hemi-thyroidectomy for thyroid cancer.
- The optimal timing for completion thyroidectomy remains a subject of clinical debate.
- Understanding the impact of surgical timing on patient outcomes is crucial for surgical decision-making.
Purpose of the Study:
- To investigate the association between the time interval from hemi-thyroidectomy to completion thyroidectomy and patient outcomes.
- To compare complication rates and functional deficits based on early versus delayed completion thyroidectomy.
Main Methods:
- Retrospective analysis of 68 patients undergoing completion thyroidectomy between August 2012 and December 2019.
- Patients were categorized into two groups: early completion thyroidectomy (≤10 days) and delayed completion thyroidectomy (≥90 days).
- Outcomes assessed included hypocalcemia, hypoparathyroidism, postoperative hospitalization, and neurological deficits (dysphonia, dysphagia, vocal cord paresis).
Main Results:
- Delayed completion thyroidectomy (n=17) was associated with significantly higher rates of hypocalcemia and/or hypoparathyroidism (P=.03) and a trend towards increased postoperative hospitalization (P=.07) compared to early completion (n=51).
- Patients undergoing delayed completion thyroidectomy had a significantly lower risk of developing dysphonia, dysphagia, or vocal cord paresis (P=.02).
- No cases of hematoma or wound infection were reported in either group.
Conclusions:
- Delayed completion thyroidectomy increases the risk of hypocalcemia and hypoparathyroidism but reduces the incidence of vocal and swallowing dysfunction.
- Considering the low overall complication rates, early completion thyroidectomy may be advantageous for expediting definitive cancer treatment.
- The findings support a balanced approach to timing completion thyroidectomy, weighing oncologic urgency against potential short-term morbidities.
