A Retrospective Study Analysis of Complications Following Completion Thyroidectomy for Differentiated Thyroid Cancer

Introduction: The main concern in modern thyroidectomy procedures is to minimise the risk of major complications like airway injury, RLN palsy and permanent hypoparathyroidism while not compromising on the outcome. When compared to unilateral thyroid lobectomy, total thyroidectomy comes with significant risk of damaging all 4 parathyroid glands and both recurrent laryngeal nerves. On the contrary completion thyroidectomy offers little risk when attempted as a second step procedure in cases of multinodular goitre with indeterminate FNAC. This study aims to assess the complications following completion thyroidectomy for differentiated thyroid cancer.

Objective: To determine the complications following completion thyroidectomy in cases of previously performed hemi thyroidectomy and with post-operative histopathology report as differentiated thyroid cancer.

Methodology: Retrospective study of 36 cases of completion thyroidectomy done in 4 years  in the department of ENT HNS , BGS Global Institute of Medical Sciences, Bengaluru.

Results: A total number of 36 patients required completion thyroidectomy over the last 4years. Transient hypoparathyroidism as the most common complication was seen in 6 cases and no case of permanent hypoparathyroidism was seen. Transient unilateral RLN weakness was seen in 4 cases whereas one patient had permanent RLN palsy. Minor complications like seroma was seen in 3 which recovered over a period of time.

Conclusion: Completion thyroidectomy is not so preferred operation often thought to carry a significantly increased risk of morbidity. However recent studies suggest that completion thyroidectomy can be performed with minimal morbidity. The complication rate of the procedure in our study was no higher than in most of the previous studies.  With the advent of newer technologies like nerve monitor, completion thyroidectomy is definitely a safe procedure, can be performed with minimal morbidity and with adequate time interval after primary hemithyroidectomy.