Thyroid Function After Unilateral Total Lobectomy

Carlucci, Dorival de; Tavares, Marcos Roberto; Obara, Marcos Takeo; Martins, Leandro Augusto Liporoni; Hojaij, Flávio; Cernea, Cláudio Roberto

doi:10.1001/archotol.134.10.1076

Cited by 55 publications

(15 citation statements)

References 17 publications

(23 reference statements)

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“…Thirty-two studies [10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41] met the inclusion criteria and were included in the meta-analysis (table 1; fig. 1).…”

Section: Resultsmentioning

confidence: 99%

“…Several factors have been evaluated in this regard by these studies shown in table 1. The two most important factors that have been widely accepted to have a significant association with postoperative hypothyroidism are preoperative TSH levels [22,23,25,26,27,28,29,30,31,32,33,34,37] and a histopathology indicative of chronic lymphocytic infiltration [23,24,25,26,28,29,31,32,33,35]. Other variables that have been studied for their significance include anti-thyroid antibodies [24,27,29,37], residual thyroid volume [27,30], preoperative free thyroxine levels [33], presence of contralateral nodule [35] and age [34].…”

Section: Discussionmentioning

confidence: 99%

“…Two studies which formulated a risk score criterion for the development of postoperative hypothyroidism used a cutoff value of 1.0-2.5 µIU/l [30,34]. Other studies use values ranging from 1.5 to 2.5 µIU/l [27,28,32,33,37]. De Carlucci et al [27] reported a 50.5% incidence of hypothyroidism in patients who had a preoperative TSH level >2 µIU/l, while three other studies [32,33,34] showed an incidence range of 37.5-58.9% in patients with a preoperative TSH level >2.5 µIU/l.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies use values ranging from 1.5 to 2.5 µIU/l [27,28,32,33,37]. De Carlucci et al [27] reported a 50.5% incidence of hypothyroidism in patients who had a preoperative TSH level >2 µIU/l, while three other studies [32,33,34] showed an incidence range of 37.5-58.9% in patients with a preoperative TSH level >2.5 µIU/l. Due to the different cutoffs used by these authors and the unavailability of all the required data from the papers, we used a cutoff level of 2.5 µIU/l to determine the RR.…”

Section: Discussionmentioning

confidence: 99%

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Hemithyroidectomy: A Meta-Analysis of Postoperative Need for Hormone Replacement and Complications

Kandil

Krishnan

Noureldine

et al. 2013

ORL

110

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Background: We sought to determine certain factors predicting postoperative need for hormone replacement therapy (HRT) after hemithyroidectomy. Methods: A PubMed search was conducted to identify articles with separate cohorts for total and hemithyroidectomy. Outcomes of interest included hypothyroidism and complications. Results: Of 50,445 patients, 15,412 (30.6%) underwent hemithyroidectomy. The reported incidence rate of postoperative hypothyroidism was 10.9-48.8%. The pooled mean preoperative thyroid-stimulating hormone (TSH) level was 1.06 µIU/l (0.83-1.29) higher in hypothyroid patients. A preoperative TSH level >2.5 µIU/l was associated with a relative risk (RR, 95% CI) of 3.16 (2.03-4.90) for postoperative hypothyroidism. There was a significant pooled RR of 3.52 (2.55-4.86) for thyroid antibodies and 3.30 (2.49-4.36) for thyroiditis on pathology for postoperative HRT. The pooled RR for postoperative complications was 10.67 (5.75-19.31) for temporary hypocalcemia, 3.17 (1.72-5.83) for permanent hypocalcemia, 1.69 (1.30-2.20) for temporary injury to the recurrent laryngeal nerve (RLN), 1.85 (1.28-2.69) for permanent RLN injury and 2.58 (1.69-3.93) for hemorrhage in patients who underwent total thyroidectomy compared to hemithyroidectomy. Conclusion: Higher preoperative TSH levels, presence of anti-thyroid antibodies and thyroiditis predict postoperative need for HRT. It is imperative to counsel patients with these findings regarding their higher risk of developing postoperative hypothyroidism and need for HRT after hemithyroidectomy.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Hemithyroidectomy: A Meta-Analysis of Postoperative Need for Hormone Replacement and Complications

Kandil

Krishnan

Noureldine

et al. 2013

ORL

110

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“…Postoperative hypothyroidism is a major complication after thyroid disorders surgeries, appeared in 32.8% of the cases in the series reported by De Carlucci et al (2008). Transient hypothyroidism incidence has been estimated to range from 6.9% to 46% (Falk et al, 1988;See and Soo, 1997;Mehrvarz et al, 2014) and permanent hypothyroidism from 0.4% to 33% (Thompson and Harness, 1970;Attie et al, 1979;Wingert et al, 1986;Falk et al, 1988) nevertheless, it depends on patients follow-up interval and their investigators in how they define hypothyroidism (Piper et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Incidences of Hypothyroidism Associated With Surgical Procedures for Thyroid Disorders: A Nationwide Population-Based Study

et al. 2019

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Background and Aim: Limited information available about different types of thyroid surgeries with risk for postoperative hypothyroidism. This study aimed to investigate the risk of developing early and late-onset postoperative hypothyroidism in patients with thyroid disorders.Methods: We used a large cohort data from the Taiwan National Health Insurance Research Data Base (NHIRDB) and identified 9,693 (9, 348) patients from January 1998 to December 2010, admitted for thyroid disorder surgeries. We used the surgical procedures time as the index date. Our observational retrospective cohort study excluded the subjects diagnosed with hypoparathyroidism and hypothyroidism before any surgeries. We analyzed the data using the Cox regression model to calculate the hazard ratio.Result: Postoperative hypothyroidism associated with bilateral-total (HR, 4.27; 95% CI, 3.32-5.50), one-side total and another subtotal (HR, 3.16; 95% CI, 2.59-3.86), bilateralsubtotal (HR, 1.65; 95% CI, 1.37-1.98), and unilateral-total (HR, 1.17; 95% CI, 0.95-1.44) surgical procedures. The time intervals for thyroid disorders were 320 cases developed postoperative hypoparathyroidism in eight weeks, 480 cases the second month, and 1000 cases in the first year after surgery.Conclusion: Findings suggest that thyroidectomy was associated with transient postoperative hypothyroidism in thyroid disorder patients. The bilateral-total surgical procedure was strongly associated with temporary postoperative hypothyroidism.

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Predictors of thyroxine replacement following hemithyroidectomy in a south east Asian cohort

Tan

et al. 2018

Head & Neck

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Background Thyroxine replacement following a hemithyroidectomy is not commonly discussed during consent for the procedure as the risk of hypothyroidism is perceived to be low. Methods Retrospective review of 901 patients who underwent hemithyroidectomy at a tertiary referral institution during the period January 2000 to December 2015. The main outcome studied was the overall incidence of hypothyroidism and the associated risk factors. Results Hypothyroidism developed in 123 (13%) patients and 94 patients (10%) required hormone supplementation over a mean follow up of 21 months (range 1‐168 months). Preoperative TSH of more than 2.5 was seen in 38 of 123 (31%) of patients. Presence of diffuse thyroiditis was the only independent risk factor on multivariate analysis (P = 0.002) found to be associated with the development of hypothyroidism. Conclusion After thyroid lobectomy, approximately one in 10 patients requiring thyroid hormone treatment for hypothyroidism. Presence of diffuse thyroiditis is a significant risk factor for hypothyroidism.

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Thyroid Function After Unilateral Total Lobectomy

Abstract: To evaluate the incidence of postoperative hypothyroidism among patients who underwent unilateral total lobectomy and identify related factors.

Cited by 55 publications

References 17 publications

Hemithyroidectomy: A Meta-Analysis of Postoperative Need for Hormone Replacement and Complications

Hemithyroidectomy: A Meta-Analysis of Postoperative Need for Hormone Replacement and Complications

Incidences of Hypothyroidism Associated With Surgical Procedures for Thyroid Disorders: A Nationwide Population-Based Study

Predictors of thyroxine replacement following hemithyroidectomy in a south east Asian cohort

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