Abstract
Background. The purpose of this study was to characterize the hypothyroidism that occurs following
hemithyroidectomy. Methods. The records of all euthyroid patients who underwent hemithyroidectomy from 1992 to
2000 were reviewed to determine the frequency of postsurgical hypothyroidism and the
predisposing factors. All patients were evaluated for age, gender, serum thyrotropin
(TSH) levels, weight of resected thyroid tissue, and associated thyroiditis. Hypothyroid
patients were evaluated for symptoms, timing of diagnosis, and treatment doses of
levothyroxine (L-T4). Results. Hypothyroidism was diagnosed in 25 (35%) of 71 patients, subclinical in 16 and overt
in 9 with a mean postoperative TSH level of 8.51 ± 6.53 μIU/L. The mean preoperative
TSH level was 1.94 ± 1.00 μIU/L in hypothyroid compared with 1.10 ± 0.74 μIU/L in
euthyroid patients (P <.05). Lymphocytic thyroiditis was present in 10 (40%) of 25 hypothyroid compared
with 10 (22%) of 46 euthyroid patients (P = not significant). There were no significant differences in age, gender, or weight
of resected thyroid tissue. The average therapeutic dose of L-T4 was 1.3 μg/kg (range, 0.5 to 1.9 μg/kg). All but 2 hypothyroid patients were diagnosed
within 2 months of operation. Conclusions. Hypothyroidism following hemithyroidectomy occurs in patients with higher preoperative
TSH levels, is usually mild and asymptomatic, and can be treated with reduced doses
of L-T4. (Surgery 2000;128:994-8.)
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Indications for thyroxine therapy after surgery for nontoxic benign goitre.Acta Chir Scand. 1990; 156: 433-438
- Thyroid function after surgical treatment of thyrotoxicosis.N Engl J Med. 1978; 298: 643-647
- Long-term follow-up of hyperthyroid patients treated by subtotal thyroidectomy.Br J Surg. 1983; 70: 408-411
- Thyroxine suppressive therapy in patients with nodular thyroid disease.Ann Intern Med. 1998; 128: 386-394
- Low serum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons.N Engl J Med. 1994; 371: 1249-1252
- Management of the unexpected result: compensated hypothyroidism.Postgrad Med J. 1998; 74: 729-732
- Prospective, randomized, double-blind study about efficacy of L-T4 therapy in prevention of recurrence after operation: result at the third year of follow-up.Surgery. 1993; 114: 1097-1101
- Preventive effect of levothyroxine in patients operated for nontoxic goitre: a randomized trial of one hundred patients with nine years follow-up.Clin Endocrinol (Oxf). 1994; 40: 323-327
- Subclinical thyroid dysfunction.Arch Intern Med. 1997; 157: 1065-1068
- Racial and age-related differences in incidence and severity of focal autoimmune thyroiditis.Am J Clin Pathol. 1994; 101: 698-702
- Subclinical hypothyroidism: natural course of the syndrome during a prolonged follow-up study.Arch Intern Med. 1993; 153: 957-961
- Levothyroxine dose requirements for thyrotropin suppression in the treatment of differentiated thyroid cancer.J Clin Endocrinol Metab. 1992; 75: 344-350
Article info
Footnotes
*Reprint requests: Christopher R. McHenry, MD, Department of Surgery, MetroHealth Medical Center, 2500 MetroHealth H918, Cleveland, OH 44109-1998.
**Surgery 2000;128:994-8.
Identification
Copyright
© 2000 Mosby, Inc. Published by Elsevier Inc. All rights reserved.