Completion thyroidectomy for differentiated thyroid carcinoma- retrospective clinical research
Alper Akcan1, Erdoğan Sözüer1, Hızır Akyıldız1, Hülya Akgün2, Can Küçük1, Engin Ok1, Yücel Arıtaş1
1Erciyes Üniversitesi Tıp Fakültesi Genel Cerrahi AD, KAYSERİ
2Erciyes Üniversitesi Tıp Fakültesi Patoloji AD, KAYSERİ
Purpose: The main indications for completion thyroidectomy are the cases that operated for the benign disease, and had a diagnosis “follicular lesion” by FNA or frozen sections, and not exactly known as malignant or not, so waited for final pathological findings to avoid from unnecessary total thyroidectomy but which have malignant diagnosis finally. We aimed to evaluate the complications of the completion operations, which had unilateral or bilateral thyroidectomy for well differentiated carcinoma previously.
Methods: We evaluated a total of 81 patients' records, who were operated for completion thyroidectomy between January 2000 and January 2007 in our clinics. Of the patients, 35 had unilateral (group 1), and 46 had bilateral (group 2) surgical intervention. Ultrasonography was performed in all study cases preoperatively and at postoperative 6th week. Sintigraphic examination was performed in 32 of group I and in 41 of group II patients preoperatively, and in all patients postoperatively.
Results: When the age (p=0.67), sex (p=0.84), thyrotoxicosis (P=0.64), the duration between the first and completion surgery (P=0.97) compared, there was no difference between the groups, but the duration of the operations of the groups were significantly different (p=0.01). Transient hypocalcemia was the most frequent (13.5%) complication after completion thyroidectomy. Permanent hypocalcemia was seen in two patients in each group. Temporary recurrent laryngeal nevre paralysis occured in 3 patient in group I, and in 4 of group II patients, and only 1 had permanent palsy.
Conclusion: Completion thyroidectomy is a surgical intervention which can be safely performed with a low morbidity by experienced surgeons. The major complication rates of the unilateral and bilateral thyroidectomy were not different in the completion operations of the well differentiated thyroid carcinoma
Keywords: well-differentiated thyroid carcinoma, completion thyroidectomy, complication