Hemithyroidectomy: A meta-analysis of postoperative need for hormone replacement and complications

Emad Kandil, Barath Krishnan, Salem I. Noureldine, Lu Yao, Ralph P Tufano

Research output: Contribution to journalArticle

Abstract

Background: We sought to determine certain factors predicting postoperative need for hormone replacement therapy (HRT) after hemithyroidectomy. Methods: A PubMed search was conducted to identify articles with separate cohorts for total and hemithyroidectomy. Outcomes of interest included hypothyroidism and complications. Results: Of 50,445 patients, 15,412 (30.6%) underwent hemithyroidectomy. The reported incidence rate of postoperative hypothyroidism was 10.9-48.8%. The pooled mean preoperative thyroid-stimulating hormone (TSH) level was 1.06 μIU/l (0.83-1.29) higher in hypothyroid patients. A preoperative TSH level >2.5 μIU/l was associated with a relative risk (RR, 95% CI) of 3.16 (2.03-4.90) for postoperative hypothyroidism. There was a significant pooled RR of 3.52 (2.55-4.86) for thyroid antibodies and 3.30 (2.49-4.36) for thyroiditis on pathology for postoperative HRT. The pooled RR for postoperative complications was 10.67 (5.75-19.31) for temporary hypocalcemia, 3.17 (1.72-5.83) for permanent hypocalcemia, 1.69 (1.30-2.20) for temporary injury to the recurrent laryngeal nerve (RLN), 1.85 (1.28-2.69) for permanent RLN injury and 2.58 (1.69-3.93) for hemorrhage in patients who underwent total thyroidectomy compared to hemithyroidectomy. Conclusion: Higher preoperative TSH levels, presence of anti-thyroid antibodies and thyroiditis predict postoperative need for HRT. It is imperative to counsel patients with these findings regarding their higher risk of developing postoperative hypothyroidism and need for HRT after hemithyroidectomy.

Original languageEnglish (US)
Pages (from-to)6-17
Number of pages12
JournalORL
Volume75
Issue number1
DOIs
StatePublished - May 2013

Fingerprint

Hormone Replacement Therapy
Hypothyroidism
Meta-Analysis
Thyrotropin
Recurrent Laryngeal Nerve Injuries
Hormones
Thyroiditis
Hypocalcemia
Thyroid Gland
Thyroidectomy
PubMed
Anti-Idiotypic Antibodies
Pathology
Hemorrhage
Antibodies
Incidence

Keywords

  • Complications
  • Hemithyroidectomy
  • Hypothyroidism
  • Meta-analysis
  • Thyroid hormone replacement
  • Thyroid nodule

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Hemithyroidectomy : A meta-analysis of postoperative need for hormone replacement and complications. / Kandil, Emad; Krishnan, Barath; Noureldine, Salem I.; Yao, Lu; Tufano, Ralph P.

In: ORL, Vol. 75, No. 1, 05.2013, p. 6-17.

Research output: Contribution to journalArticle

Kandil, Emad ; Krishnan, Barath ; Noureldine, Salem I. ; Yao, Lu ; Tufano, Ralph P. / Hemithyroidectomy : A meta-analysis of postoperative need for hormone replacement and complications. In: ORL. 2013 ; Vol. 75, No. 1. pp. 6-17.
@article{31dba1d5643c4f69b00d24212be46cfd,
title = "Hemithyroidectomy: A meta-analysis of postoperative need for hormone replacement and complications",
abstract = "Background: We sought to determine certain factors predicting postoperative need for hormone replacement therapy (HRT) after hemithyroidectomy. Methods: A PubMed search was conducted to identify articles with separate cohorts for total and hemithyroidectomy. Outcomes of interest included hypothyroidism and complications. Results: Of 50,445 patients, 15,412 (30.6{\%}) underwent hemithyroidectomy. The reported incidence rate of postoperative hypothyroidism was 10.9-48.8{\%}. The pooled mean preoperative thyroid-stimulating hormone (TSH) level was 1.06 μIU/l (0.83-1.29) higher in hypothyroid patients. A preoperative TSH level >2.5 μIU/l was associated with a relative risk (RR, 95{\%} CI) of 3.16 (2.03-4.90) for postoperative hypothyroidism. There was a significant pooled RR of 3.52 (2.55-4.86) for thyroid antibodies and 3.30 (2.49-4.36) for thyroiditis on pathology for postoperative HRT. The pooled RR for postoperative complications was 10.67 (5.75-19.31) for temporary hypocalcemia, 3.17 (1.72-5.83) for permanent hypocalcemia, 1.69 (1.30-2.20) for temporary injury to the recurrent laryngeal nerve (RLN), 1.85 (1.28-2.69) for permanent RLN injury and 2.58 (1.69-3.93) for hemorrhage in patients who underwent total thyroidectomy compared to hemithyroidectomy. Conclusion: Higher preoperative TSH levels, presence of anti-thyroid antibodies and thyroiditis predict postoperative need for HRT. It is imperative to counsel patients with these findings regarding their higher risk of developing postoperative hypothyroidism and need for HRT after hemithyroidectomy.",
keywords = "Complications, Hemithyroidectomy, Hypothyroidism, Meta-analysis, Thyroid hormone replacement, Thyroid nodule",
author = "Emad Kandil and Barath Krishnan and Noureldine, {Salem I.} and Lu Yao and Tufano, {Ralph P}",
year = "2013",
month = "5",
doi = "10.1159/000345498",
language = "English (US)",
volume = "75",
pages = "6--17",
journal = "ORL; journal for oto-rhino-laryngology and its related specialties",
issn = "0301-1569",
publisher = "S. Karger AG",
number = "1",

}

TY - JOUR

T1 - Hemithyroidectomy

T2 - A meta-analysis of postoperative need for hormone replacement and complications

AU - Kandil, Emad

AU - Krishnan, Barath

AU - Noureldine, Salem I.

AU - Yao, Lu

AU - Tufano, Ralph P

PY - 2013/5

Y1 - 2013/5

N2 - Background: We sought to determine certain factors predicting postoperative need for hormone replacement therapy (HRT) after hemithyroidectomy. Methods: A PubMed search was conducted to identify articles with separate cohorts for total and hemithyroidectomy. Outcomes of interest included hypothyroidism and complications. Results: Of 50,445 patients, 15,412 (30.6%) underwent hemithyroidectomy. The reported incidence rate of postoperative hypothyroidism was 10.9-48.8%. The pooled mean preoperative thyroid-stimulating hormone (TSH) level was 1.06 μIU/l (0.83-1.29) higher in hypothyroid patients. A preoperative TSH level >2.5 μIU/l was associated with a relative risk (RR, 95% CI) of 3.16 (2.03-4.90) for postoperative hypothyroidism. There was a significant pooled RR of 3.52 (2.55-4.86) for thyroid antibodies and 3.30 (2.49-4.36) for thyroiditis on pathology for postoperative HRT. The pooled RR for postoperative complications was 10.67 (5.75-19.31) for temporary hypocalcemia, 3.17 (1.72-5.83) for permanent hypocalcemia, 1.69 (1.30-2.20) for temporary injury to the recurrent laryngeal nerve (RLN), 1.85 (1.28-2.69) for permanent RLN injury and 2.58 (1.69-3.93) for hemorrhage in patients who underwent total thyroidectomy compared to hemithyroidectomy. Conclusion: Higher preoperative TSH levels, presence of anti-thyroid antibodies and thyroiditis predict postoperative need for HRT. It is imperative to counsel patients with these findings regarding their higher risk of developing postoperative hypothyroidism and need for HRT after hemithyroidectomy.

AB - Background: We sought to determine certain factors predicting postoperative need for hormone replacement therapy (HRT) after hemithyroidectomy. Methods: A PubMed search was conducted to identify articles with separate cohorts for total and hemithyroidectomy. Outcomes of interest included hypothyroidism and complications. Results: Of 50,445 patients, 15,412 (30.6%) underwent hemithyroidectomy. The reported incidence rate of postoperative hypothyroidism was 10.9-48.8%. The pooled mean preoperative thyroid-stimulating hormone (TSH) level was 1.06 μIU/l (0.83-1.29) higher in hypothyroid patients. A preoperative TSH level >2.5 μIU/l was associated with a relative risk (RR, 95% CI) of 3.16 (2.03-4.90) for postoperative hypothyroidism. There was a significant pooled RR of 3.52 (2.55-4.86) for thyroid antibodies and 3.30 (2.49-4.36) for thyroiditis on pathology for postoperative HRT. The pooled RR for postoperative complications was 10.67 (5.75-19.31) for temporary hypocalcemia, 3.17 (1.72-5.83) for permanent hypocalcemia, 1.69 (1.30-2.20) for temporary injury to the recurrent laryngeal nerve (RLN), 1.85 (1.28-2.69) for permanent RLN injury and 2.58 (1.69-3.93) for hemorrhage in patients who underwent total thyroidectomy compared to hemithyroidectomy. Conclusion: Higher preoperative TSH levels, presence of anti-thyroid antibodies and thyroiditis predict postoperative need for HRT. It is imperative to counsel patients with these findings regarding their higher risk of developing postoperative hypothyroidism and need for HRT after hemithyroidectomy.

KW - Complications

KW - Hemithyroidectomy

KW - Hypothyroidism

KW - Meta-analysis

KW - Thyroid hormone replacement

KW - Thyroid nodule

UR - http://www.scopus.com/inward/record.url?scp=84874812325&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84874812325&partnerID=8YFLogxK

U2 - 10.1159/000345498

DO - 10.1159/000345498

M3 - Article

C2 - 23486083

AN - SCOPUS:84874812325

VL - 75

SP - 6

EP - 17

JO - ORL; journal for oto-rhino-laryngology and its related specialties

JF - ORL; journal for oto-rhino-laryngology and its related specialties

SN - 0301-1569

IS - 1

ER -