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Research Articles and Papers on:

Thyroidectomy

 

Five-year follow-up for a randomised clinical trial of unilateral thyroid lobectomy with or without postoperative levothyroxine treatment.

World J Surg. 2010 Jun;34(6):1232-8.
Barczynski M, Konturek A, Golkowski F, et al

The researchers wanted to compare how often a nodular goiter returned in the other thyroid lobe among patients who had had one lobe removed.  They did this by looking at some patients who had received levothyroxine after the operation and some patients who didn’t receive levothyroxine.

The study ran from January 2000 to December 2003. 150 consenting patients had an operation to remove one lobe and they were put into two groups of 75 patients.  Patients in group A received prophylactic (protective) LT4 treatment postoperatively (dose range 75-125 microg/day to maintain thyroid-stimulating hormone values below 1.0 mU/L), whereas patients in group B received no postoperative LT4 treatment.

All the patients had ultrasound scans, cellular and biochemical tests for at least 60 months after the operation.

During the 5-year follow-up, among patients receiving LT4, 1.4% of patients had a recurrent goitre. In the group not receiving levothyroxine 16.7% of patients had a recurrent goitre.

Also, 1.4% of patients receiving LT4 required surgery on the other lobe but 8.3% of patients not receiving LT4 required surgery on the other lobe.

LT4 decreased the recurrence rate among iodine-deficient patients (3.4% vs. 36%, respectively but not among iodine-sufficient patients (0% vs. 6.4%, respectively).

The researchers concluded that prophylactic LT4 treatment significantly decreased the recurrence rate of nodular goiter in the other thyroid lobe and therefore the need to have both lobes removed, mostly among patients with iodine deficiency.

The clinical raters from this study commented that the study was very small and needs to be confirmed.