Safety of Completion Thyroidectomy for Thyroid Cancer

ABSTRACT

PURPOSE: Completion thyroidectomy is defined as the surgical removal of the remnant thyroid tissue following procedures less than total thyroidectomy. However the roles and indications of completion thyroidectomy remain controversial. This study was performed to review the clinical and pathologic features of patients who underwent completion thyroidectomy and to evaluate the safety of this procedure. METHODS: A retrospective analysis from Nov. 1994 to Dec. 2002 at Samsung Medical Center yielded 36 patients, 11 male and 25 female, who had undergone completion thyroidectomy. Their median follow-up was 29 months. RESULTS: The patients ranged in age from 20 to 58 years. Of the 36 patients, 24 had undergone prophylactic thyroidectomy and 12 therapeutic thyroidectomy for recurrence. The most common cause of completion thyroidectomy was cancers undiagnosed during the primary operation and 12 cases (75%) among these 16 undiagnosed cancers were follicular carcinoma. Three patients harbored carcinoma at the perithyroidal lymph node or remnant thyroid as a result of prophylactic completion thyroidectomy. Postoperative complications occurred in 11 patients (31%): 10 transient hypocalcemia and 1 transient hoarseness. There were no differences in postoperative complication rate between total thyroidectomy group and completion thyroidectomy during the same period at our hospital. CONCLUSION: The most common indication that is considered for completion thyroidectomy is a follicular carcinoma undiagnosed during primary operation. Completion thyroidectomy might be a safe operation with minimal morbidity if it is performed meticulously by an experienced surgeon.