Introduction
Materials and methods
Study design and patient selection
Randomization
Anesthesia
Surgical technique
Preoperative evaluation and postoperative follow-up
Statistical analysis
Results
TT
n = 177 | DO
n = 174 | BST
n = 175 | |
---|---|---|---|
Sex ratioa (M:F) | 15:162 | 18:156 | 15:160 |
Mean ageb (years) | 45.9 ± 13.9 | 47.0 ± 15.3 | 47.9 ± 15.2 |
Preoperative TSHb (mIU/L) | 1.87 ± 0.84 | 1.82 ± 0.81 | 1.80 ± 0.91 |
Preoperative thyroid volume (assessed by ultrasound)a (mL) | 75.8 ± 38.4 | 77.8 ± 39.5 | 78.8 ± 39.9 |
Primary endpoints
TT | P TT versus DO | DO | P DO versus BST | BST | P TT versus BST | |
---|---|---|---|---|---|---|
Lost to follow-up at 10 years | 23 (11.5) | 0.296 | 26 (13.0) | 0.329 | 25 (12.5) | 0.343 |
Recurrent goiter [no (%)] | 1 (0.6) |
<0.001
| 15 (8.6) |
<0.001
| 39 (22.3) |
<0.001
|
Need for revision thyroidectomy [no (%)] | 1 (0.6) | 0.070 | 5 (2.9) |
0.019
| 14 (8.0) |
<0.001
|
Secondary endpoints
TT | P TT versus DO | DO | P DO versus BST | BST | P TT versus BST | |
---|---|---|---|---|---|---|
Risk of initial thyroid surgery (n = 600)
a
| ||||||
n
| 200 | 200 | 200 | |||
Hypoparathyroidism [no (%)] | ||||||
Total | 22 (11.5) |
0.007
| 8 (4.2) | 0.241 | 4 (2.1) |
<0.001
|
Transient | 21 (11.0) |
0.012
| 8 (4.2) | 0.241 | 4 (2.1) |
<0.001
|
Permanent | 1 (0.5) | 0.316 | 0 (0) | 1.000 | 0 (0) | 0.316 |
Recurrent laryngeal nerve injury [no (%)] | ||||||
Total | 25 (6.5) | 0.352 | 19 (5.0) | 0.088 | 10 (2.6) |
0.009
|
Temporary | 21 (5.5) | 0.399 | 16 (4.2) | 0.097 | 8 (2.1) |
0.014
|
Permanent | 4 (1.0) | 0.704 | 3 (0.8) | 0.653 | 2 (0.5) | 0.412 |
Hemorrhage [no (%)] | 0 (0) | 0.316 | 1 (0.5) | 0.562 | 2 (1.0) | 0.156 |
Risk of revision thyroidectomy (n = 20)
b
| ||||||
n
| 1 | 5 | 14 | |||
Hypoparathyroidism [no (%)] | ||||||
Total | 0 (0) | 1.000 | 3 (60.0) | 1.000 | 10 (71.4) | 0.333 |
Transient | 0 (0) | 1.000 | 1 (10.0) | 1.000 | 5 (35.7) | 1.000 |
Permanent | 0 (0) | 1.000 | 2 (40.0) | 1.000 | 5 (35.7) | 1.000 |
Recurrent laryngeal nerve injury [no (%)] | ||||||
Total | 0 (0) | 1.000 | 3 (60.0) | 0.411 | 5 (17.8) | 1.000 |
Temporary | 0 (0) | 1.000 | 1 (20.0) | 1.000 | 2 (7.1) | 1.000 |
Permanent | 0 (0) | 1.000 | 2 (40.0) | 0.592 | 3 (10.7) | 1.000 |
Hemorrhage [no (%)] | 0 (0) | 1.000 | 0 (0) | 1.000 | 1 (7.1) | 1.000 |
Cumulative risk of initial and revision thyroidectomy (n = 526)
a
| ||||||
Permanent hypoparathyroidism [no (%)] | 1 (0.6) | 0.555 | 2 (1.1) | 0.252 | 5 (2.9) | 0.097 |
Permanent recurrent laryngeal nerve injury [no (%)] | 4 (1.1) | 0.717 | 5 (1.4) | 1.000 | 5 (1.4) | 0.724 |
Hemorrhage [no (%)] | 1 (0.6) | 1.000 | 1 (0.6) | 0.317 | 3 (1.7) | 0.309 |