INCIDENCE OF DEVELOPMENT OF HYPOTHYROIDISM FOLLOWING HEMITHYROIDECTOMY

Neeraj Upadhyay, Sachchidanand Tewari

Abstract


Objective: To investigate the incidence, time to onset, and risk factors for the development of hypothyroidism after hemithyroidectomy.

Background: The incidence and risk factors for hypothyroidism in patients undergoing partial thyroid surgery remains unclear. Hypothyroidism is an under-appreciated sequel of hemithyroidectomy. The early recognition of this postoperative complication m ay prevent symptom s of hypothyroidism and recurrent thyroid disease.

Methods: We conducted a prospective observational study of patients undergoing hemithyroidectomy from July 2010 to July 2011 at department of General Surgery, CSM Medical University, Lucknow. Patients were analyzed for age, sex, family history of thyroid disease, pre and postoperative thyroid stimulating hormone (TSH), histological diagnosis, size of residual thyroid gland, histological evidence of thyroiditis, and time period to develop hypothyroidism.

Results: Hypothyroidism was diagnosed in 22.7% of 26 patients. The mean time to diagnosis was within 4.5 months. Patients with postoperative hypothyroidism had a higher incidence of a high-norm al preoperative TSH level. Age, gender, family history of thyroid disease, thyroid pathology, and weight of resected tissue were not significant risk factors for hypothyroidism.

Conclusions: An incidence of 22.7% is higher than anticipated and all patients should have postoperative thyroid function assessment. However, a high-norm al preoperative TSH levels is indications for close monitoring.


Keywords


Hypothyroidism, Hemithyroidectomy, Thyroid Function Test, General Surgery.

Full Text:

PDF

References


Buchanan M A and Lee D. Thyroid auto-antibodies, lymphocytic infiltration and the development of post-operative hypothyroidism following hemithyroidectomy for nontoxic nodular goitre. JR Coll Surg Edinb. 2001 Apr;46(2):86-90.

Niepomniszcze H, Garcia A, Faure E, Castellanos A, del Carmen Zalazar M , Bur G, Elsner B. Long-term follow up of contralateral lobe in patients hemithyroidectomized for solitary follicular adenoma. Clin Endocrinol (Oxf). 2001 Oct;55(4):509-13

Piper HG, Bugis SP, Wilkins GE, Walker BA, Wisem an S, Baliski CR. Detecting and defining hypothyroidism after hemithyroidectomy. Am J Surg. 2005 M ay; 189(5):587- 91.

Miller FR, Paulson D, Prihoda TJ, Otto RA. Risk Factors for the Development of Hypothyroidism after Hemithyroidectomy. Arch Otolaryngol Head Neck Surg. 2006;132:36-38

Seiberling KA, Dutra JC, Bajaramovic S. Hypothyroidism following hemithyroidectomy for benign nontoxic thyroid disease. Ear Nose Throat J. 2007 May;86(5):295-9.

Su SY, Serpell J. ES16P hypothyroidism following hemithyroidectomy ANZ Journal of Surgery Volume 77, Issue Supplement S1, page A24, May 2007

Koh WY, Lee SW, Choi EC, Lee JD, Mok JO, Kim HK , Koh ES, Lee JY, Kim SC. Prediction of hypothyroidism after hemithyroidectomy: a biochemical and pathological analysis. Eur Arch Otorhinolaryngol (2008) 265:453-457

Moon HG, Jung EJ, Park ST, Jung TS, Jeong CY, Ju YT, Lee YJ, Hong SC, Choi SK , Ha WS. Thyrotropin level and thyroid volume for Prediction of Hypothyroidism following Hemithyroidectomy in an Asian Patient Cohort. World J Surg (2008) 32:2503-2508

Carlucci Jr DD, Tavares M R, Obara M T, Martins LAL, Hojaij FC, Cermea CR. Thyroid Function After Unilateral Total Lobectomy : Risk Factors for Postoperative Hypothyroidism Arch Otolaryngol Head Neck Surg. 2008;134(10):1076-1079


Refbacks

  • There are currently no refbacks.