Outcomes of Early Versus Delayed Completion Thyroidectomy for Malignancy

Abstract

Purpose To determine whether time interval between hemi-thyroidectomy and subsequent completion thyroidectomy impacts outcomes. Methods Retrospective review of 68 patients having completion thyroidectomy from August 2012 to December 2019. Patients were separated into two groups based on the time interval between surgeries: early (≤10 days) or delayed (≥90 days). Results Patients who underwent delayed completion thyroidectomy (n = 17) had significantly higher rates of hypocalcemia and/or hypoparathyroidism ( P = .03) and higher rates of requiring postoperative hospitalization ( P=.07) compared to those who underwent early completion thyroidectomy (n = 51). Delayed completion had significantly lower risk of developing one or more of dysphonia, dysphagia, or vocal cord paresis postoperatively ( P=.02). No patients developed hematoma or wound infection. Conclusions Delayed completion thyroidectomy is associated with increased rates of hypocalcemia, but lower rates of dysphonia and dysphagia. Given the low risk of long-term complications in both groups, it may be beneficial to perform completion thyroidectomy early in order to expedite cancer treatment.

Risk of Complications in Patients Undergoing Completion Thyroidectomy after Hemithyroidectomy for Thyroid Nodule with Indeterminate Cytology: An Italian Multicentre Retrospective Study

“…Some authors recommend performing completion surgery either within the first 10 days or after 3 months, reporting increased complication rates in a completion thyroidectomy performed in the intermediate postoperative period (between 10 days and 3 months). However, other studies concluded that timing has no influence on morbidity [36,37].…”

Completion thyroidectomy: A safe option for high‐volume surgeons

“…2,17,18 One study reported lower rates of hypocalcemia/hypoparathyroidism ( p = 0.03) as well as dysphonia (p = 0.02) in patients undergoing early (≤10 days) as compared to those undergoing delayed (≥90 days) completion thyroidectomy. 35 Another limitation is that our study did not restrict the indications for each surgery type. While different indications (e. g., goiter) may be technically more difficult and increase the risk of complication, the different operations performed reflect the true nature of an endocrine practice.…”

“…The optimal time for cT has been suggested by multiple studies and is accordingly reported in the American Thyroid Association guidelines to be performed within 6 months of the operation 2,17,18 . One study reported lower rates of hypocalcemia/hypoparathyroidism ( p = 0.03) as well as dysphonia ( p = 0.02) in patients undergoing early (≤10 days) as compared to those undergoing delayed (≥90 days) completion thyroidectomy 35 . Another limitation is that our study did not restrict the indications for each surgery type.…”