Completion thyroidectomy: A safe option for high-volume surgeons

Area of Science:

• Endocrinology
• Surgical Oncology
• Head and Neck Surgery

Background:

• The comparative risk of complications following completion thyroidectomy (cT) versus other thyroidectomy procedures remains debated.
• Existing studies present conflicting data regarding whether cT poses an increased or decreased risk of complications compared to total thyroidectomy (TT).

Purpose of the Study:

• To compare complication rates among thyroid lobectomy (TL), total thyroidectomy (TT), and completion thyroidectomy (cT) performed by a single high-volume surgeon.
• To evaluate the safety and outcomes of different thyroidectomy approaches in a single-institution setting.

Main Methods:

• A retrospective cohort study was conducted.
• Patients undergoing TL, TT, or cT by a high-volume surgeon were identified and included.
• Complication rates were collected and analyzed across the three surgical cohorts.

Main Results:

• A total of 310 patients were analyzed, with an overall complication rate of 4.2%.
• Complication rates were 1% for TL, 7.1% for TT, and 4.5% for cT (p=0.10).
• Transient hypocalcemia was more frequent in TT (6.1%) than TL (0%) or cT (0.9%) (p=0.01), and recurrent laryngeal nerve signal loss was similar across groups (TL: 0%, TT: 1%, cT: 3.6%, p=0.10).

Conclusions:

• Despite a trend towards fewer complications with less extensive procedures, no statistically significant differences in complication rates were found among TL, TT, and cT when performed by a high-volume surgeon.
• Given the overall low complication rates, patient counseling and individual preferences should guide the selection of appropriate and tailored surgical treatment plans.