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Updated: May 22, 2025

Mixed Reality Assisted Radical Endoscopic Thyroidectomy
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Does Completion Thyroid Surgery Pose a Higher Risk of Complications?

Alaa Sada1, Kimberly M Ramonell1, Kelly L McCoy1

  • 1Department of Surgery, Division of Endocrine Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

World Journal of Surgery
|March 14, 2025
PubMed
Summary

Completion thyroidectomy (CT) shows similar complication rates to thyroid lobectomy (TL). Total thyroidectomy (TT) has higher risks of temporary and long-term hypoparathyroidism compared to CT.

Keywords:
endocrinehead and neckoutcomes

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Area of Science:

  • Endocrine Surgery
  • Surgical Outcomes
  • Thyroid Cancer Management

Background:

  • Completion thyroidectomy (CT) outcomes are not well-documented.
  • Comparing CT risks to total thyroidectomy (TT) and thyroid lobectomy (TL) is crucial for patient care.
  • A large multi-institutional database is utilized to assess these risks.

Purpose of the Study:

  • To compare the complication risks of total thyroidectomy (TT), thyroid lobectomy (TL), and completion thyroidectomy (CT).
  • To evaluate short-term and long-term outcomes for different thyroidectomy types.
  • To determine if CT poses a higher risk than TL.

Main Methods:

  • Utilized the CESQIP national database (2013-2023) for thyroidectomy cases without lymphadenectomy.
  • Defined CT as contralateral lobectomy post-initial lobectomy.
  • Examined outcomes including hematoma, vocal cord dysfunction, and hypoparathyroidism.

Main Results:

  • Hematoma rates were low across TT (0.8%), TL (0.5%), and CT (<0.7%).
  • Vocal cord dysfunction rates were similar for TT (1.4%), TL (1.3%), and CT (1.0%).
  • Temporary hypoparathyroidism was more common after TT (6%) than CT (2%); long-term hypoparathyroidism was also higher after TT (2.5%) vs. CT (0.7%).

Conclusions:

  • Completion thyroidectomy (CT) has comparable long-term complication rates to thyroid lobectomy (TL).
  • Total thyroidectomy (TT) is associated with significantly higher rates of both temporary and long-term hypoparathyroidism compared to CT.
  • CT does not appear to pose a higher risk of complications than TL.