TOTAL VERSUS COMPLETION THYROIDECTOMY IN MANAGEMENT OF SUSPECTED THYROID CARCINOMA

Abstract

Background: When results of the FNA are reported as indeterminate, a hemi- or total thyroidectomy may be performed, depending on the suspicion of cancer. Objective: This work was designed is to compare the incidence of complications and surgical outcome of total and completion thyroidectomy in management of suspected thyroid carcinoma Patients and methods: The study included 50 patients with STN and results of the FNA are reported as (indeterminate or a follicular lesion). They divided into 2 groups. (Group I) include 20 patients (40%) were subjected to Completion thyroidectomy and (Group II) include 30 patients (60 %) were subjected to total thyroidectomy. All cases were operated upon in the department of General Surgery department, Zagazig University Hospitals during the period of the research from May 2010 to July 2013.Statistical analysis: SPSS version 19.Results: In the present study there was 38 (76%) were males and 12 (24%) were female and the pathology of residual tissue in (Group I) showed 8 case (40%) had residual malignancy and 12 cases (60.0%) are free from malignancy. From this study the hospital stay in (Group I) ranges from 5 to 8 days with The mean stay was ( 5.9 ± 1.0 days ) which is longer than (group II) ranges from 3 to 5 days with The mean stay was(3.7 ± 0.75 days).From this study the development of hypoparathyroidism was greater in (Group I) (20%) than (group II) (10%) and recurrent laryngeal nerve injury was greater in (Group I) (4%) than (Group II) (2%).Conclusion: The frequency of complications was greater in (Group I) than (Group II) so total thyroidectomy is considered as the treatment of choice for both malignant and benign thyroid disease requiring surgical treatment when performed by experienced surgeons Moreover, it eliminates the requirement of completion thyroidectomy for incidentally diagnosed thyroid carcinoma.