A comparison of total thyroidectomy and lobectomy in the treatment of dominant thyroid nodules

Farkas, E. A., King, T. A., Bolton, J. S. and Fuhrman, G. M. (2002). A comparison of total thyroidectomy and lobectomy in the treatment of dominant thyroid nodules. In: Annual Meeting of the Southeastern Surgical Congress, Nashville, TN, United States, (678-682). 1-5 February 2002.

Author Farkas, E. A.
King, T. A.
Bolton, J. S.
Fuhrman, G. M.
Title of paper A comparison of total thyroidectomy and lobectomy in the treatment of dominant thyroid nodules
Conference Paper Type Fully Published Paper
Conference name Annual Meeting of the Southeastern Surgical Congress
Conference location Nashville, TN, United States
Conference dates 1-5 February 2002
Journal name American Surgeon
Publisher Southeastern Surgical Congress
Publication date 2002
Volume number 68
Issue number 8
ISSN 0003-1348; 1555-9823
Start page 678
End page 682
Total pages 4
Language eng
Abstract/Summary Patients with a clinically concerning dominant thyroid nodule have been managed by lobectomy or total thyroidectomy at our institution. We determined the complications associated with both approaches and the ability of thyroid lobectomy to avoid the need for thyroid hormone replacement therapy. Records of all patients with a dominant thyroid nodule managed with surgery from August 1993 through December 2000 were reviewed for demographics, history of head and neck radiation, indication for surgery, preoperative fine-needle aspirate results, final pathologic evaluation, perioperative complications, determinations of need for subsequent thyroid surgery after lobectomy, and need for thyroid hormone replacement therapy after surgery. Patients with a preoperative diagnosis of malignancy or bilateral or diffuse disease were excluded because these conditions would uniformly be managed by bilateral thyroidectomy. The complications for the lobectomy group (n = 131) compared with the total thyroidectomy group (n = 84) were: recurrent laryngeal nerve paresis (4.6% vs 2.4%), recurrent laryngeal nerve injury (0.8% vs 0), and transient hypoparathyroidism (1.5% vs 9.5%; P = 0.007). No permanent hypoparathyroidism was identified in either group. Postoperative thyroid hormone replacement was required in 64 of 131 lobectomy patients (48.8%). Complications associated with either surgery were low. Total thyroidectomy was not associated with clinically significant additive morbidity. Patients treated by lobectomy should be aware of a nearly 50 per cent chance of requiring thyroid hormone replacement. Total thyroidectomy avoids future thyroid surgery; lobectomy patients remain at risk. When complications can be minimized total thyroidectomy should be considered an option in the management for patients with dominant thyroid nodules that require surgery.
Keyword FINE-NEEDLE ASPIRATION
FOLLICULAR NEOPLASMS
NECK IRRADIATION
MANAGEMENT
DISEASE
COMPLICATIONS
CARCINOMA
HEAD
Q-Index Code E1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Conference Paper
Sub-type: Fully Published Paper
Collection: School of Medicine Publications
 
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