Hemi-Thyroidectomy versus Total Thyroidectomy in Management of Papillary Thyroid Carcinoma

Papillary thyroid cancer (PTC) is the most common form of thyroid cancer, accounting for nearly 70% of all thyroid tumours. In terms of thyroid cancer, differentiated thyroid carcinoma is the most prevalent kind. A good prognosis may be expected if the cancer has not spread to the lymph nodes or distant organs, however this is dependent on the kind of cancer and other prognostic markers such as age, gender, lymph node involvement, and distant metastasis. As many as 11% to 30% of patients with early stage I and II PTC relapse after surgical resection, according to certain studies. There are several variables to consider when determining how extensive a patient's surgery should be, including the tumor's size, how far it has spread (local or distant), and the patient's medical history. Micropapillary carcinoma occurs when the initial tumour is smaller than 10mm in diameter. The capacity to offer radioactive iodine treatment to ablate leftover thyroid, even metastatic disease, and the ability to follow up for tumour recurrence using serum thyroglobulin levels are all potential advantages of a total thyroidectomy. In cases when the tumour is less than 2 cm in diameter, unifocal, and does not extend beyond the thyroid gland, a hemi thyroidectomy is advised. As a surgical option for papillary thyroid cancer therapy, the research aims to compare hemi-thyroidectomy with whole thyroidectomy for recurrence rates, hypoparathyroidism and the frequency of re-operations due to recurrence. Methods: Papillary thyroid cancer was confirmed by FNAC and pathology reports prior to surgery in 40 patients at banha university hospital, 20 of them received hemi-thyroidectomy and the other 20 underwent complete thyroidectomy. From 2010 to 2020, the research will be conducted. Vocal cord palsy and tumour recurrence were shown to be indistinguishable between the two surgeries throughout the research period of up to three years. (P=1.00). Radioactive iodine ablation (P=0.487) is an option for management. Succeeding operations as an alternative method of care in the event that the disease returns (P=0.487) and recurrence-free survival. Patients who had a whole thyroidectomy were more likely to develop hypoparathyroidism than those who had a hemi-thyroidectomy. In spite of this, the P-value was just 0.02. A complete thyroidectomy for PTC treatment resulted in hypoparathyroidism in 30% of patients, either transitory or permanent. Hypoparathyroidism as a side effect of hemi-thyroidectomy has never been documented. For patients with papillary thyroid carcinoma who have been properly selected, hemi-thyroidectomy is an appropriate surgical option because it does not significantly differ from total thyroidectomy in terms of recurrent laryngeal nerve injury, the use of radioactive iodine, hypoparathyroidism and tumour recurrence rates.