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Completion Thyroidectomy in a Patient with Differentiated Thyroid Cancer

  • Serdar Özbaş
  • Seyfettin Ilgan
Chapter

Abstract

A considerable number of patients, undergoing less than total or near-total thyroidectomy as an initial surgical treatment, will need reoperation for incidentally found thyroid carcinoma on final histopathology to provide complete resection of possible multicentric disease or to allow for efficient radioiodine therapy. In the 2015 American Thyroid Association guidelines for the management of thyroid cancer, completion thyroidectomy was offered to patients for whom a bilateral thyroidectomy would have been recommended had the diagnosis been available before the initial surgery. Older age (>45 years), contralateral suspicious thyroid nodules, a personal history of radiation therapy to the head and neck, and the existence of familial differentiated thyroid cancer should be taken into account to recommend a bilateral procedure to facilitate either radioiodine therapy or follow-up. Since a significant proportion of thyroid surgery is still being performed by low-volume surgeons, the discovery of large remnant tissue even after so-called total thyroidectomy is not a rare issue. To enhance the safety and success of completion thyroidectomies, new technologies and guiding methods are being used more often including intraoperative nerve monitoring, preoperative and intraoperative USG mapping, and gamma surgical probe.

Keywords

Thyroid cancer Completion thyroidectomy Radioguided surgery 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Serdar Özbaş
    • 1
  • Seyfettin Ilgan
    • 2
  1. 1.Department of SurgeryGüven HospitalAnkaraTurkey
  2. 2.Department of Nuclear MedicineGüven HospitalAnkaraTurkey

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