Need for thyroxine in patients lobectomised for benign thyroid disease as assessed by follow-up on average fifteen years after surgery.

Thyroid lobectomy is a common procedure. It is therefore important to know whether lobectomised patients need thyroxine substitution after operation for benign disease. A follow-up examination of 95 patients on average 15 years after surgery disclosed hypothyroidism in 5%. There were seven individuals (9%) with only elevated thyrotropin values but normal thyroxine values or only borderline thyroxine values. The completeness of the lobectomy was checked by means of technetium scintigrams. Patients on thyroxine treatment were investigated twice, the second time after discontinuing thyroxine for at least six weeks. There were no goiter recurrences indicating reoperation. No patient who had been operated on for a follicular adenoma had signs of malignant conversion or follicular recurrence, regardless of thyroxine treatment or not. We conclude that routine prescription of thyroxine is not warranted for lobectomised patients. It seems preferable to offer these patients occasional follow-up for functional assessment and thyroid palpation.