Completion Thyroidectomy and Total Thyroidectomy for Differentiated Thyroid Cancer: Comparison and Prediction of Postoperative Hypoparathyroidism

Background: Consensus regarding the difference of postoperative hypoparathyroidism following completion thyroidectomy (CT) and total thyroidectomy (TT) has yet to be reached. We compare the occurrence of postoperative hypoparathyroidism between CT and TT for differentiated thyroid cancer (DTC), and explore the predictive factors for postoperative hypoparathyroidism. Methods: We retrospectively reviewed 221 consecutive patients underwent CT or TT for DTC between February 2012 and March 2014. Patients' demographic and clinical data of the two groups were analyzed. Results: There were 57 CTs and 164 TTs. Temporary hypoparathyroidism occurred in 12.3% (7 of 57) and 28.0% (46 of 164) of patients in the CT and TT groups, respectively. In univariate analysis, type of surgical procedure (CT or TT) and extent of central lymph node dissection (CND) (unilateral or bilateral) were significantly associated with the postoperative temporary hypoparathyroidism (P<0.05). Multivariate analysis showed that only the extent of CND was an independent risk factor for temporary hypoparathyroidism. Conclusions: Although temporary hypoparathyroidism was lower in the CT group, our analysis indicates the difference is due to the extent of CND rather than type of surgical procedure (CT vs. TT). Only bilateral CND is an independent risk factor for temporary hypoparathyroidism after thyroidectomy. (C) 2016 Wiley Periodicals, Inc.