Completion Thyroidectomy Versus Total Thyroidectomy: Complication Rates

摘要

Objetives. This study compared our experience with completion thyroidectomy and total thyroidectomy in the management of well-differentiated thyroid cancer. We compared complication rates and analyzed the implications of the intraoperative management of the parathyroid glands. Methods We perfomed a retrospective cohort study comparing outcomes between patients undergoing completion thyroidectomy and total thyroidectomy between October 1984 and august 1999. All patients had surgery for either suspected or confirmed well –diffeerentiated thyroid cancer on fine –needle aspiration. Results. A total of 100 completion thyroidectomy and 75 total thyroidectomy were studied. Mean hospital stays were 4,5 and 3.5 days, for the completion thyroidectomy y total thyroidectomy group, respectively (p= 0.001).Temporary recurrent laryngeal nerve paresis occurred in 2% and 6.6% of patients in the completion thyroidectomy and total thyroidectomy group, respectively. There was one case of permanent recurrent laryngeal nerve paralysis in the completion thyroidectomy. Permanent hypoparathyroidism rates were 5% y 6.6% in the completion thyroidectomy and thyroidectomy total group, respectively. There was no difference between the two groups in terms of total mumbers of parathyroid glands autotransplanted (p=0.63) or present in the specimen (p=0.26). Conclusions. Completion thyroidectomy is a safe and appropriate option in the management of selected cases of well diffferentiated thyroid cancer in which a definitive preoperative or intraoperative diagnosis is not available, but it requires a longer hospitalization, so it has implications for both hospital resources and the patients involved.