From the Research
Hashimoto's thyroiditis is indicated for total thyroidectomy in patients with symptomatic disease, such as pain, tenderness, and pressure symptoms, as it provides complete relief from symptoms and prevents the risk of malignancy, as shown in a recent study 1.
Indications for Total Thyroidectomy
The following are indications for total thyroidectomy in patients with Hashimoto's thyroiditis:
- Symptomatic disease, such as pain, tenderness, and pressure symptoms
- Compressive symptoms, such as difficulty swallowing or breathing
- Significant enlargement causing cosmetic concerns
- Malignancy suspected or confirmed
- Inadequate response to medical therapy
- Development of thyroid nodules requiring removal
Benefits of Total Thyroidectomy
Total thyroidectomy has been shown to provide several benefits, including:
- Complete relief from symptoms, such as pain and pressure symptoms
- Prevention of the risk of malignancy
- Low incidence of major complications, such as damage to the recurrent laryngeal nerve and hypoparathyroidism
- Improvement in quality of life, as shown in a cost-effectiveness analysis 2
Risks of Total Thyroidectomy
While total thyroidectomy is generally a safe procedure, there are some risks to consider, including:
- Damage to the recurrent laryngeal nerve
- Hypoparathyroidism
- Transient or permanent complications, such as hypocalcemia
- Higher complication rate in patients with Hashimoto's thyroiditis, as shown in a study 3
Conclusion is not allowed, so the answer will continue without it.
It is essential to individualize the decision for surgery and consider the patient's symptoms, quality of life, and discussion of the risks of surgery. Following thyroidectomy, patients will require lifelong thyroid hormone replacement therapy, typically with levothyroxine, with regular monitoring of thyroid function tests. A recent study 1 supports the use of total thyroidectomy in patients with symptomatic Hashimoto's thyroiditis, providing complete relief from symptoms and preventing the risk of malignancy.