Initial versus Staged Thyroidectomy for Differentiated Thyroid Cancer: A Retrospective Multi-Dimensional Cohort Analysis of Effectiveness and Safety.

The optimal surgical approach for differentiated thyroid cancer remains controversial, with debate regarding the comparative risks of upfront total thyroidectomy versus staged completion thyroidectomy following the initial lobectomy. This study aimed to assess the complication rates associated with these two strategies and identify the optimal timing for completion thyroidectomy using a multi-dimensional analysis of four cohorts: an institutional series ( = 148), the National Surgical Quality Improvement Program (NSQIP) database ( = 39,992), the TriNetX repository ( > 30,000), and a pooled literature review (10 studies, = 6015). Institutional data revealed higher overall complication rates with total thyroidectomy (18.