Comparative Study between Total Thyroidectomy and Hemithyroidectomy in Treatment of Solitary Thyroid Nodules Diagnosed as Follicular Lesions by Fine-Needle Aspiration Cytology

Abstract

Background: Thyroid nodular (TN) lesions are a common clinical problem in the world. These are more common in women and in areas of iodine deficiency. Exposure to ionizing radiation in childhood and adolescence increases the risk of solitary thyroid nodule and thyroid carcinoma. Objective: Determination of the optimal surgical approach for individuals undergoing thyroidectomy for solitary thyroid nodule identified as indeterminate follicular lesion on preoperative fine needle aspiration cytology (FNAC) diagnosis and to estimate the long term outcome of patients treated by lobectomy for solitary follicular thyroid nodule. Patients and methods: From June 2017 to June 2019, 50 patients having a solitary thyroid nodule with a cytological diagnosis of “indeterminate follicular lesion” were selected prospectively. Results: There were 26 women and 24 men with a mean age of 56 years (range: 28-83). Hemithyroidectomy (HT) was performed in 25 patients (50%) and a total thyroidectomy (TT) in 25 (50%). Postoperative morbidity was 3.50% in patients who underwent HT and 9.75% in those who underwent TT. At the histological analysis 3 (12%) patients of hemithyroidectomy group had a malignant lesion. Conclusions: Considering the high rate in which HT represents the adequate treatment, and the low rate of reoperation morbidity, HT seems to be the preferable initial surgical approach for indeterminate follicular lesions. Long-term ultrasonographic follow-up seems advisable.