[Comments on the prevention of recurrence with thyroid hormone therapy]

Hemithyroidectomy is the basic operation for isolate thyroid nodules or unilateral multinodular goiters. However, surgeons must check the absence of contralateral nodules by palpation, in order to avoid residual nodules that are not readily amenable to hormone therapy. In a review of 1456 goiters operated between 1968 and 1983, the authors identify only the multinodular nature as a significant risk factor of recurrence. In view of the prevention of residual nodules, they note only 2.5% recurrence. Although some studies demonstrate an increase in the TSH level after hemithyroidectomy, these results do not allow recommending systematic postoperative hormone therapy. This seems to be justified only in a population at risks, namely patients with multinodular goiter, increased postoperative TSH levels, thyroiditis or a family history.