Analysis of Safety of Completion Thyroidectomy: Comparison between Prophylactic Operation Group and Therapeutic Operation Group.
- Author:
Yoon Woo KOH
1
;
Seung Won LEE
;
Hyo Jin KIM
;
Yong Man LEE
;
Sung Woon KIM
;
Jung Yeol LEE
;
Ji Oh MOK
;
Dong Won BYUN
Author Information
1. Department of Otolaryngology-Head & Neck Surgery, Soonchunhyang University, College of Medicine, Bucheon, Korea. ywkohent@schbc.ac.kr
- Publication Type:Original Article
- Keywords:
Hypocalcemia;
Recurrent laryngeal nerve;
Thyroidectomy
- MeSH:
Biopsy;
Biopsy, Fine-Needle;
Carcinoma, Papillary;
Follow-Up Studies;
Hypocalcemia;
Hypoparathyroidism;
Length of Stay;
Parathyroid Glands;
Pathology;
Recurrent Laryngeal Nerve;
Recurrent Laryngeal Nerve Injuries;
Retrospective Studies;
Thyroid Gland;
Thyroidectomy*
- From:Korean Journal of Otolaryngology - Head and Neck Surgery
2006;49(8):817-823
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: Completion thyroidectomy (CT) is defined as the resection of residual thyroid tissue following the initial operation of less than a total thyroidectomy. But completion thyroidectomy is a rare surgical procedure associated with increased morbidity and is related to recurrent laryngeal nerve injury and hypoparathyroidism. The purpose of present study is to evaluate the various clinical and pathological situation of completion thyroidectomy (CT) and the safety of completion thyroidectomy (CT) according to various parameters. SUBJECTS AND METHOD: From February 2001 through July 2005, 32 consecutive cases who underwent completion thyroidectomy (CT) were retrospectively analyzed. Prophylactic CT was performed in 17 cases and therapeutic CT was performed in 15 cases. Their mean follow-up was 19.8+/-0.6 months (3-44 months). The various parameters were retrospectively analyzed between two groups. These parameters included the time interval between the first and second operations, complication associated with CT, duration of hospital stay, preoperative imaging, preoperative fine needle aspiration cytology, frozen biopsy and permanent pathology. RESULTS: Prophylactic CT was composed of ten cases of follicular carcinoma and seven cases of papillary carcinoma. Therapeutic CT was composed of four cases of papillary carcinoma, one case of follicular carcinoma and 10 cases of benign nodule. The time interval between the first and second operations was 48.9+/-1.3 days (prophylactic CT) and 15.1+/-.8 years (therapeutic CT). The duration of hospital stay was not significantly different between two groups. Transient hypocalcemia occurred in 11.8% (2/17, prophylactic CT) and 13.3% (2/15, therapeutic CT), respectively. Permanent hypocalcemia occurred in 5.9% (1/17, prophylactic CT) and 6.7% (1/15, therapeutic CT). Recurrent laryngeal nerve injury occurred in 0% (0/17, prophylactic CT) and 13.3% (2/15, therapeutic CT) Hypocalcemia was not significantly different between two groups, but the difference of recurrent laryngeal nerve injury was significant. CONCLUSION: Completion thyroidectomy might be a safe operation with minimal morbidity. However, in those therapeutic CT cases where previous operation records are unavailable, special care was needed in preserving the recurrent laryngeal nerve and parathyroid gland. We also suggest that even in unilateral thyroidectomy, the parathyroid gland should be preserved.
