Follow-up after surgery for benign nodular thyroid disease: evidence-based approach

Abstract
Background  There is no consensus on what constitutes appropriate methodology and timing for follow-up of patients after surgery for benign
nodular disease.

Methods  A systematic review of the medical literature using evidence-based criteria was used to address the following four issues:
(1) How often should patients who have undergone thyroidectomy for the treatment of benign nodular goiter be followed, and
what constitutes appropriate follow-up? (2) What is the most appropriate method for detecting recurrent nodular thyroid disease?
(3) Does thyroid hormone administration prevent recurrent nodular thyroid disease? (4) Does iodine administration prevent
recurrent nodular thyroid disease?

Results  Altogether, 742 articles were found in MEDLINE using a keyword search strategy; we then narrowed them to 23 articles. There
were a total of four articles with Level I data, five articles with Level II data, one article with Level III data, and 13
articles with Level IV or retrospective data.

Conclusions  Based on the available data, it is our recommendation that patients undergoing thyroid lobectomy for benign nodular thyroid
disease should be followed with an annual physical examination, neck ultrasonography, and serum thyroid-stimulating hormone
(TSH) measurement. Patients undergoing total thyroidectomy should be followed with an annual physical examination and a serum
TSH measurement. Routine thyroxine and/or iodine supplementation may be useful for preventing recurrence in patients from
iodine-deficient regions.

Content Type Journal ArticleDOI 10.1007/s00268-008-9487-yAuthors
Roy Phitayakorn, MetroHealth Medical Center, Case Western Reserve University School of Medicine Department of Surgery 2500 MetroHealth Drive Cleveland OH 44109 USAChristopher R. McHenry, MetroHealth Medical Center, Case Western Reserve University School of Medicine Department of Surgery 2500 MetroHealth Drive Cleveland OH 44109 USA

Journal World Journal of SurgeryOnline ISSN 1432-2323Print ISSN 0364-2313 (Source: World Journal of Surgery)