Completion thyroidectomy can be done safely
after thyroid lobectomy in patients with thyroid carcinoma
(November 2002)
The background of
the study. Patients with a thyroid nodule are often treated
by removal of the thyroid lobe containing the nodule (thyroid lobectomy).
However, if the nodule proves to be a follicular or papillary carcinoma,
removal of the other thyroid lobe-so-called completion thyroidectomy-is
often recommended. This study was done to determine the safety of
completion thyroidectomy.
How the study was done. The study
subjects were all 36 patients (32 women, 4 men; mean age, 44 years)
who underwent thyroid lobectomy and then completion thyroidectomy
by one surgeon between 1997 and 2000.
The results of the study. The diagnoses
at the initial operation were follicular variant of papillary carcinoma
in 29 patients (80 percent), follicular carcinoma in 6 patients
(17 percent), and Hurthle-cell carcinoma in 1 patient (3 percent).
The completion thyroidectomy, performed 2 to 103 days (mean, 43)
after the initial thyroid lobectomy, revealed thyroid carcinoma
in 20 of the 36 patients (56 percent). The pathological diagnosis
was follicular variant of papillary carcinoma in 18 patients (50
percent), follicular carcinoma in 1 patient (3 percent), and Hurthle-cell
carcinoma in 1 patient (3 percent). No tumor was found in 16 patients
(44 percent). Few patients had any permanent side effects after
either operation.
The conclusions of the study. Completion
thyroidectomy can be performed safely a few days or many weeks after
initial thyroid lobectomy. The operation reveals thyroid carcinoma
in approximately 50 percent of patients.
The original article. Kupferman
ME, Mandel SJ, DiDonato L, Wolf P, Weber RS. Safety of completion
thyroidectomy following unilateral lobectomy for well-differentiated
thyroid cancer. Laryngoscope 2002;112:1209-12.
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