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Posthemithyroidectomy Hypothyroidism: Updated Meta-Analysis of Risk Factors and Rates of Remission
Konstantinos Apostolou1, Ivan Paunovic2, Maximos Frountzas3
1First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece.
The Journal of Surgical Research
|September 21, 2023
Summary
Post-hemithyroidectomy, hypothyroidism affects 29% of patients, with subclinical hypothyroidism being most common. Risk factors include older age, female gender, and specific antibody presence, necessitating personalized treatment strategies.
Area of Science:
- Endocrinology
- Surgical Oncology
- Public Health
Background:
- Post-hemithyroidectomy hypothyroidism is a common complication in euthyroid patients.
- Understanding its incidence, risk factors, and remission rates is crucial for patient management.
Approach:
- A systematic literature search was conducted in Medline, Web of Science, and Cochrane Library.
- Meta-analysis and metaregression were used to pool data from 54 studies involving 9,999 patients.
Key Points:
- The pooled hypothyroidism rate after hemithyroidectomy was 29%, with subclinical hypothyroidism in 79% of cases.
- Older age, female gender, higher preoperative TSH, positive anti-TPO/anti-Tg antibodies, and right-sided surgery increased hypothyroidism risk.
- Hypothyroidism remission rate was 42%, with significant regional variations observed (Asia higher than Europe/Canada).
Conclusions:
- Hypothyroidism is a frequent postoperative sequela of hemithyroidectomy.
- Individualized treatment strategies are essential, considering the risk factors for hypothyroidism development and remission.
