Prevalence of and Predictive Factors for Hypothyroidism Following Hemithyroidectomy

Hemithyroidectomy is an appropriate procedure that is recommended for a number of thyroid conditions to preserve the functional contralateral thyroid lobe, but patients who underwent a hemithyroidectomy still run the risk of developing hypothyroidism. This study aimed to determine the incidence of hypothyroidism following a hemithyroidectomy as well as predictive risk factors.

A retrospective analysis was carried out on all patients who underwent hemithyroidectomy between 2016 and 2022. Age, gender, preoperative and postoperative thyroid stimulating hormone (TSH) and free thyroxin (FT4), side, and volume of the remaining lobe, as well as the histologic diagnosis, were all examined in the patients. To identify the predictors of hypothyroidism, statistical analyses, both univariate and multivariate, were conducted.

Out of 224 patients, 18.25% had hypothyroidism following surgery. This complication appeared within the first year in 88% of the cases. Patients with thyroiditis (P = .036), preoperative TSH levels greater than 1.72 mIU/L (P < .001), right side hemithyroidectomy (P = .017), and residual lobe volume less than 3.57 cm (P < .001) had a significantly higher risk of developing hypothyroidism.

After hemithyroidectomy, hypothyroidism is a major complication that should be carefully evaluated preoperatively based on risk factors of hypothyroidism. Furthermore, our results confirm the need for routine serum TSH monitoring for a minimum of 1 year following hemithyroidectomy.