Surgical considerations for thyroid tumours

  • Thyroid lobectomy
    • 25% may require long-term thyroid hormone replacement
    • Thyroid replacement may not be available
    • TSH/T3/T4 monitoring may be unavailable
  • Total thyroidectomy
    • Transient hypocalcaemia in 5-60%
    • Permanent hypocalcaemia in 1.5-5%
    • Calcium monitoring and replacement may not be available
    • Hypocalcaemia may be fatal
  • Bilateral RLN injury may be fatal
  • Central neck dissection increases complication rates (RLN and hypocalcaemia)
  • Occasional thyroid surgeons have higher hypocalcaemia and RLN complication rates
  • If RAI unavailable
    • Must rely on curative surgical treatment
    • May not require total thyroidectomy
  • Follow-up may be unreliable

Index: Clinical Practice Guidelines for Thyroid