POSTOPERATIVE COMPLICATIONS AFTER COMPLETION THYROIDECTOMY FOR DIFFERENTIATED THYROID-CANCER

The surgical approach to differentiated thyroid carcinoma is still con troversial, as many authors consider it necessary to remove the whole gland, Therefore, when definitive histological diagnosis is made follo wing limited resection, re-operation and completion thyroidectomy (CT) is sometimes recommended. The main indications are for follicular can cer or for patients with a carcinoma of greater than or equal to 1 cm previously treated with lobectomy or limited resection (early CT), or for local recurrence after previous treatment (late CT), Several autho rs, however, draw attention to the high rate of complications followin g completion thyroidectomy and advocate its use in more limited circum stances, The aim of the study was to evaluate the results of our exper ience with CT in the National Cancer Institute in Naples, Of 131 patie nts treated for thyroid cancer 35 (26.7%) underwent a CT, Re-operation was performed within 6 months in 26 cases (74.3%) and later in the re maining nine cases (25.7%) : carcinoma in the residual gland was found in six cases (23%) of early CT, and in four casts (45%) in the late C T group with an overall incidence of 28.5%, Post-operative complicatio ns were: transient hypoparathyroidism, two cases (5.6%), permanent in one (2.8%). Transient recurrent laryngeal nerve palsy occurred in thre e patients (8.5%) and became permanent in one case (2.8%). Completion thyroidectomy can therefore be considered a safe procedure.