title: Completion thyroidectomy for malignancy after initial minimal access thyroid surgery.
abstract: BACKGROUND
  Minimal access thyroid surgery (MATS), carried out through a lateral 2.5-cm incision, provides excellent clinical and cosmetic outcomes when carried out for small (<3 cm), single nodules. However, if the final pathology shows thyroid malignancy and a completion thyroidectomy is required, the small lateral incision requires conversion to a standard collar incision and the second operation must be carried out in the presence of previous lateral dissection. The aim of this study is to determine if there is any demonstrable disadvantage to completion thyroidectomy for malignancy after MATS when compared with the same procedure after conventional hemithyroidectomy.
  
  
  METHODS
  This retrospective cohort study examined all patients undergoing completion thyroidectomy for malignancy in the University of Sydney Endocrine Surgical Unit from January 2002 to January 2005. Outcome measures were complication rates, final scar length and patient's self-assessment of scar appearance.
  
  
  RESULTS
  A total of 106 patients underwent MATS during the study period, 11 of whom required completion thyroidectomy for malignancy. During the same period, 42 patients required completion thyroidectomy for malignancy after previous conventional hemithyroidectomy. There was no difference in complication rates between the two groups. The two complications in the study consisted of one case of flap oedema (control) and one case of keloid scar (MATS). Mean final incision length, scar appearance and patient's satisfaction with scar did not differ between the two groups.
  
  
  CONCLUSIONS
  There is no demonstrable disadvantage when completion thyroidectomy for malignancy is required after MATS.
authors.affiliation: Department of Surgery, University of Sydney Endocrine Surgical Unit, Royal North Shore Hospital, Sydney, New South Wales, Australia.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Yeh
authors.forename: Stan B
authors.initials: SB
authors.lastname: Sidhu
authors.forename: Mark
authors.initials: M
authors.lastname: Sywak
authors.forename: Pamela
authors.initials: P
authors.lastname: Edhouse
authors.forename: Leigh W
authors.initials: LW
authors.lastname: Delbridge
mesh_terms: D000328:Adult; D002921:Cicatrix / Q000209:etiology / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D017060:Patient Satisfaction; D012086:Reoperation; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome