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Optimum Timing and Complication of Completion Thyroidectomy for Differentiated Thyroid Cancer

Research Authors
Mohamed Abouelmagd Salem, Badawy M. Ahmed, Mahmoud H. Elshoieby
Research Department
Research Year
2017
Research Journal
Journal of Cancer Therapy
Research Publisher
NULL
Research Vol
Vol.8
Research Rank
1
Research_Pages
PP.518-526
Research Website
DOI: 10.4236/jct.2017.85044
Research Abstract

Background: Despite improved preoperative diagnostics, incidental postoperative
detection of differentiated thyroid cancer in the final histology is still
common. In most of these cases, completion thyroidectomy is recommended
by national and international guidelines, although secondary surgery is associated
with an increased operative risk. The optimal timing of completion
thyroidectomy is still controversial. Patients and Methods: The patients admitted
to surgical oncology department, SECI, with diagnosis of differentiated
thyroid cancer; during the period from January 2008 to December 2015;
were rewired for age, sex, type of 1st operation, histopathological result, type of
2nd operation and time interval between the 2 operation, complication of 2nd
operation and morbidity. 118 patients underwent completion thyroidectomy;
those patients were divided according to timing of completion operation into
3 groups: Group A is from one week to 3 months and include 64 patients;
Group B is from 3 - 6 months and include 30 patients; Group C is more than 6
months and include 24 patients. Clinical complications and oncologic outcomes
were analyzed. The mean follow-up was 80 ± 10 months. Result: we
record 118 patients under completion thyroidectomy. Ages range from 79 to
13 years. Papillary thyroid cancer were 96 and follicular thyroid cancer were
22. The overall rates of transient and persistent postoperative hypocalcemia
were 19.5% and 4.2%, respectively. The rates of persistent hypocalcemia were
found in group A and B but not in group C. Transient or persistent vocal cord
paresis was observed in 9 (7.6%) and 3 patients (2.5%). The incidence of persistent
vocal cord paresis (VCP) was significantly higher in groups A and B
than in group C. There was no significant difference regarding survival among
the 3 groups; however recurrence is higher in group A. Conclusion: Considering
perioperative morbidity and oncologic outcomes, completion thyroidectomy
should be performed at least 3 to 6 months after primary surgery.