Endocrine Abstracts

Background and aims: Less than total thyroidectomy (lobectomy, partial or subtotal thyroidectomy) is used mainly to treat thyroid nodules, and/or hyperthyroidism. The aim of the study was to investigate the long term effects of less extensive surgical procedures. such as re-appearance of nodules and the need of thyroxin supplementation, or re-operation.

Material and methods: Retrospective study in a tertiary Academic medical center. The study population comprised initially 76 patients. Of whom 67 patients (age±S.D.: 64.1±13.3, 58 (86.5%) females) who underwent lobectomy, partial thyroidectomy or subtotal thyroidectomy with benign histology and a follow-up equal or longer to 5 years were included (9 excluded). None the patients appeared post-surgery permanent iatrogenic hypoparathyroidism or recurrent laryngeal nerve injury.

Results: Mean follow up was 22.1±10.8 years. Patients who underwent lobectomy, partial thyroidectomy and subtotal thyroidectomy were 24 (35.8%), 9 (13.5%) and 34 (50.7%), respectively. Patients received thyroxin replacement were 62 (92.5%). Relapse as defined by re-appearance of nodules or recurrence of hyperthyroidism in total population was in 39 (58.2%) patients: 70.8% (17/24) in lobectomy group; 77.8% (7/9) in partial thyroidectomy, and 44.1% (15/34) in subtotal thyroidectomy group, respectively. Re-operation underwent 7 patients (10.4%) of total or 17.9% of the recurrence cases. Univariate analysis showed that the type of operation and the length of follow up were predictors for relapse (OR: 1.81, 95%CI: 1.03–3.19, P=0.038 and OR: 0.92, 95%CI: 0.87–0.97, P=0.002, respectively). Multivariate analysis showed that the length of follow up was superior independent factor predicting relapse (OR: 0.92, 95%CI: 0.87–0.98, P=0.006).

Conclusions: The majority of patients received thyroxin replacement. The length of follow-up and the type of operation have an impact on relapse, but mostly the length of follow up. Treatment with total thyroidectomy could eventually avoid a relapse and a possible need for re-operation.