What is Completion Thyroidectomy?
Completion thyroidectomy is a surgical procedure performed to remove the remaining thyroid tissue after an initial partial thyroidectomy. It is usually done when the initial surgery removed only part of the thyroid gland, but later findings such as cancer, suspicious nodules, or persistent thyroid disease require removal of the rest of the gland. This ensures complete treatment and prevents future complications related to the thyroid.
Symptoms That May Lead to Completion Thyroidectomy
Patients may require a completion thyroidectomy if they experience:
- Persistent thyroid nodules
- Diagnosis of thyroid cancer after initial surgery
- Recurrent hyperthyroidism (overactive thyroid)
- Compression symptoms due to thyroid tissue growth
- Voice changes or swallowing difficulties if related to thyroid remnants
- Abnormal hormone levels not managed by medications alone
Procedure / Treatment
Completion thyroidectomy is performed under general anaesthesia. During the procedure:
- Incision: A small incision is made in the lower neck along the previous surgical scar.
- Identification: Surgeons carefully identify vital structures like the recurrent laryngeal nerve and parathyroid glands to prevent injury.
- Removal: The remaining thyroid tissue is surgically removed.
- Closure: The incision is closed with sutures, and a small drain may be placed temporarily to prevent fluid accumulation.
The surgery duration depends on the amount of remaining thyroid tissue and complexity. Most patients are discharged within 1-2 days post-surgery.
Prevention
While completion thyroidectomy itself is a treatment, its need can sometimes be reduced by:
- Thorough preoperative evaluation with ultrasound and FNAC (Fine Needle Aspiration Cytology)
- Comprehensive surgical planning to remove suspicious tissue in the first surgery
- Regular follow-up and monitoring for thyroid nodules or cancer
Benefits of Completion Thyroidectomy
- Complete removal of cancerous or suspicious tissue
- Prevents recurrence of thyroid disease
- Improves control of thyroid hormone levels
- Reduces risk of further surgeries in the future
- Provides clarity for further treatments like radioactive iodine therapy if needed
Types of Thyroidectomy Procedures
Although completion thyroidectomy refers specifically to removal of remaining thyroid tissue after partial surgery, thyroidectomy in general includes:
- Total Thyroidectomy: Removal of the entire thyroid gland.
- Partial (Hemi) Thyroidectomy: Removal of one lobe of the thyroid.
- Completion Thyroidectomy: Removal of remaining thyroid tissue after previous partial removal.
- Subtotal Thyroidectomy: Removal of a large part of the gland but leaving a small portion.