COMPLETION THYROIDECTOMY FOR DIFFERENTIATED THYROID-CARCINOMA

Completion thyroidectomy is defined as the surgical removal of the rem nant thyroid tissue following procedures less than total or near-total thyroidectomy. The extent of surgical management for differentiated t hyroid carcinoma (DTC) is controversial, Although some authors advocat e subtotal thyroidectomy with lower complication rates, total or near- total thyroidectomy and completion thyroidectomy have been defended by others because of the improved survival and lower morbidity that is c omparable with subtotal thyroidectomy, In this study, the incidence of residual tumor and surgical complication rates in patients who underw ent completion thyroidectomy were investigated. The medical records of 165 patients undergoing completion thyroidectomy for DTC were reviewe d. Seventy-seven (46.6%) of these patients were found to have residual tumor in the remaining thyroid tissue. Anaplastic transformation deve loped in two of these patients, Permanent bilateral recurrent laryngea l nerve palsy occurred in three patients, and permanent hypoparathyroi dism was seen in one patient. We recommend completion thyroidectomy as an efficient and safe method of surgical treatment with a low complic ation rate for DTC. (C) 1995 Wiley-Liss, Inc.