Completion Thyroidectomy: Revisited a Quarter of a Century Later
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The excellent outcome for patients with thyroid cancer is increasingly recognized, with Japan and the United States considerably interested in observing selected microcarcinomas.1,2 In the last decade, our experience has shown that most thyroid microcarcinomas can be observed safely.3 It therefore is understandable why the potential overtreatment of thyroid cancer has been debated, not only among professionals, but also in the media and general public.
The complications of thyroidectomy may be worse than the thyroid cancer itself, and the complications are directly related to the extent of surgery. Even experienced surgeons report a 1% rate of permanent hypoparathyroidism when both thyroid lobes are removed.4–7Conversely, this complication is virtually unknown after thyroid lobectomy. Some patients may require thyroid hormone supplementation after thyroid lobectomy, but it appears to be tolerated much better than full replacement, which is needed after total thyroidectomy. Certain...
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