Prevalence of and risk factors for hypothyroidism after hemithyroidectomy: a systematic review and meta-analysis.
Abstract
Purpose This systematic review and meta-analysis evaluated the prevalence of and risk factors for hypothyroidism following hemithyroidectomy as new evidence obtained in recent years warranted an update of previous meta-analyses.Methods The PubMed, Embase, and Cochrane Library databases were searched through November 1, 2019, for articles examining the hypothyroidism prevalence and risk factors after lobectomy. The prevalence rate, risk ratio (RR), weighted mean difference (WMD) and standardized mean difference (SMD) were assessed by conducting a meta-analysis of proportions, binary variables, and continuous variables, respectively, using random-effects models.Results Fifty-one studies showed a pooled risk of 29.9% (95% confidence interval (CI), 24.6-35.2%) for hypothyroidism following hemithyroidectomy. Risk factors for the development of postoperative hypothyroidism included the female sex (RR, 1.169; 95% CI, 1.040-1.314; P = 0.009), a higher preoperative thyrotropin (TSH) level (RR, 2.955; 95% CI, 2.399-3.640; P = 0.000), a lower preoperative FT4 level (SMD, -0.818; 95% CI, -1.623--0.013; P = 0.047), concomitant lymphocyte infiltration (RR, 1.558; 95% CI, 1.203-2.018; P = 0.001), Hashimoto's thyroiditis (HT) (RR, 1.480; 95% CI, 1.192-1.838; P = 0.000), a lighter weight of the remaining gland (WMD, -2.740; 95% CI, -3.708--1.772; P = 0.000), and a right side lobectomy (RR, 1.404; 95% CI, 1.075-1.835; P = 0.013).Conclusions Hypothyroidism is a significant complication after lobectomy, and appropriate and personalized surgical strategies should be designed after a careful preoperative assessment based on the estimated risk of hypothyroidism and risk factors.
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Up to 42% of patients develop hypothyroidism over a span of 7 years after radiation therapy for head and neck cancer.
“Approximately 25% to 34% of patients require treatment with levothyroxine after hemithyroidectomy, and up to 42% develophypothyroidismoveraspanof7yearsafterradiationtherapy for head and neck cancer. 26,27”
From Hypothyroidism: A Review (2025) · cites this paper as [27]
Approximately 25% to 34% of patients require treatment with levothyroxine after hemithyroidectomy.
“Approximately 25% to 34% of patients require treatment with levothyroxine after hemithyroidectomy, and up to 42% develophypothyroidismoveraspanof7yearsafterradiationtherapy for head and neck cancer. 26,27”
From Hypothyroidism: A Review (2025) · cites this paper as [27]
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- Authors
- Li, Z., Qiu, Y., Fei, Y., Xing, Z., Zhu, J., & Su, A.
- Affiliations
- Sichuan University (CN)
- Corresponding author
- Su, Anping
- Venue
- Endocrine
- Published
- 2020-07-07
- Volume
- 70
- Issue
- 2
- Pages
- 243-255
- ISSN
- 0969-711X (ISSN-L)
- 1355-008X
- 1559-0100
- OpenAlex
- W3041558611
- Cited by
- 58
- References
- 65
- Citations by year
- 2026: 8 · 2025: 15 · 2024: 9 · 2023: 10 · 2022: 10 · 2021: 5 · 2020: 1
- FWCI
- 1.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Endocrine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Keywords
- postoperative hypothyroidism, hemithyroidectomy, lobectomy, thyroidectomy complications, risk factors, prevalence, free thyroxine, Hashimoto's thyroiditis, lymphocyte infiltration, sex differences, thyroid hormone replacement, thyroid autoimmunity
- MeSH terms
- Female, Humans, Hypothyroidism, Risk Factors, Thyroidectomy, Thyrotropin, Prevalence
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