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Thyroid hormone replacement after thyroid lobectomy

2009; Elsevier BV; Volume: 146; Issue: 4 Linguagem: Inglês

10.1016/j.surg.2009.06.026

1532-7361

Samantha J. Stoll, Susan C. Pitt, Jing Liu, Sarah Schaefer, Rebecca S. Sippel, Herbert Chen,

Thyroid and Parathyroid Surgery

Background-The purpose of this study was to determine the incidence of and identify risk factors for post-operative hypothyroidism in patients undergoing thyroid lobectomy.Methods-We retrospectively reviewed patients who underwent a thyroid lobectomy for benign disease from May 2004 to December 2007.Patients with known hypothyroidism or on preoperative thyroid hormone replacement were excluded.Results-In this study, 14.3% of patients developed hypothyroidism and required thyroid hormone supplementation.These hypothyroid patients had a higher mean pre-operative TSH and lower mean free T4 serum levels compared to euthyroid patients (TSH: 2.12 vs. 1.35 µIU/ml, P=0.006; free T4: 1.03 vs. 1.34 ng/dl, P=0.01, respectively).When stratified into three groups based on their preoperative TSH measurement (≤ 1.5, 1.51 -2.5, and ≥ 2.51 µIU/ml), the rate of hypothyroidism increased significantly at each level (13.5%, 20.5%, and 41.3%, respectively, P 1.5 µIU/ml, lower free T4 levels, and Hashimoto's thyroiditis are at increased risk and should be counseled and followed appropriately.