Document Detail


Surveillance and intervention after thyroid lobectomy.
MedLine Citation:
PMID:  21246403     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: After thyroid lobectomy, many patients require ongoing care. This study sought to quantify the rates of surveillance and intervention after thyroid lobectomy.
METHODS: One hundred one consecutive patients who underwent a thyroid lobectomy for nodular disease were evaluated. Clinical and follow-up data were obtained by a review of patient charts and included an evaluation of resource utilization related to thyroid disease.
RESULTS: Nineteen patients required completion thyroidectomy for thyroid cancer, and 11 had hypothyroidism before lobectomy. Of the remaining evaluable patients, 30 (42.2%) of 71 required thyroid hormone replacement after lobectomy, with 24 patients having elevated thyroid-stimulating hormone and 6 suppression of nodules in the contralateral lobe. The likelihood of thyroid hormone replacement demonstrated a trend with a contralateral nodule (9 of 14 vs. 21 of 57, P = 0.06) and a significant association with thyroiditis on surgical pathology (10 of 11 vs. 20 of 60, P < 0.001). Of the 82 patients who did not undergo completion lobectomy, 10 (12%) of 82 underwent postoperative fine-needle aspiration of the contralateral lobe, and 25 (30%) of 82 were followed with ultrasound surveillance. Only 27% of patients treated with lobectomy required no further surveillance or intervention. There were no instances of permanent recurrent laryngeal nerve injury.
CONCLUSIONS: After thyroid lobectomy, most patients require continued surveillance and intervention. With a near-zero complication rate, total thyroidectomy may be a more effective and efficient option for management of nodular thyroid disease.
Authors:
Philip M Spanheimer; Sonia L Sugg; Geeta Lal; James R Howe; Ronald J Weigel
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Publication Detail:
Type:  Journal Article     Date:  2011-01-19
Journal Detail:
Title:  Annals of surgical oncology     Volume:  18     ISSN:  1534-4681     ISO Abbreviation:  Ann. Surg. Oncol.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-05     Completed Date:  2011-08-30     Revised Date:  2012-01-11    
Medline Journal Info:
Nlm Unique ID:  9420840     Medline TA:  Ann Surg Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1729-33     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, Iowa.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Biopsy, Fine-Needle
Child
Child, Preschool
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neoplasm Recurrence, Local / prevention & control*
Retrospective Studies
Survival Rate
Thyroid Neoplasms / pathology,  surgery*,  ultrasonography
Thyroidectomy*
Thyrotropin
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
9002-71-5/Thyrotropin
Comments/Corrections
Comment In:
Ann Surg Oncol. 2011 Dec;18 Suppl 3:S308; author reply S309   [PMID:  21748245 ]

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