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Hypothyroidism after hemithyroidectomy: a systematic review and meta-analysis
Dominic Cooper1, Rajneesh Kaur, Femi E Ayeni2,3
1The University of Sydney School of Medicine, Sydney, Australia.
Thyroid Research
|July 7, 2024
Summary
Nearly 30% of patients develop hypothyroidism after hemithyroidectomy, with risk factors including pre-operative thyroid stimulating hormone levels and female sex. Understanding these factors aids in patient counseling and management of post-surgical thyroid function.
Area of Science:
- Endocrinology
- Surgical Oncology
- Thyroidology
Background:
- Hypothyroidism incidence and risk factors post-hemithyroidectomy remain unclear.
- This review examines post-operative hypothyroidism, thyroxine needs, and transient cases.
Purpose of the Study:
- To systematically review the incidence of hypothyroidism and thyroxine supplementation after hemithyroidectomy.
- To identify risk factors associated with post-operative hypothyroidism.
- To analyze the course of post-operative hypothyroidism, including time to onset and transient rates.
Main Methods:
- Systematic literature search of MEDLINE, EMBASE, Scopus, and Cochrane Library.
- Inclusion of studies reporting hypothyroidism incidence or thyroxine supplementation post-hemithyroidectomy.
Main Results:
- Pooled incidence of hypothyroidism was 29%; transient hypothyroidism occurred in 34% of patients.
- Thyroxine supplementation was needed in 23% of patients; overt hypothyroidism in 4%.
- Key risk factors included pre-operative TSH levels, female sex, age, right-sided surgery, and autoimmune thyroid conditions.
Conclusions:
- A substantial proportion of patients develop hypothyroidism or require thyroxine post-hemithyroidectomy.
- Awareness of risk factors and post-operative course is crucial for patient counseling and management.
- Informed patient guidance on individual risk profiles is essential.
