TOTAL THYROIDECTOMY AS PRIMARY ELECTIVE PROCEDURE IN MULTINODULAR THYROID DISEASE
Abstract
Background: Multinodular goitre is one of the commonest thyroid diseases encountered in thepractice of surgery. The most common surgery being performed for multinodular goitre is subtotalthyroidectomy. Total thyroidectomy is designed to remove all of the thyroid tissue. The objectiveof this study was to evaluate total thyroidectomy as a primary elective procedure for treatment ofmultinodular thyroid disease. This descriptive study was carried out at Combined Military HospitalRawalpindi from June 2003 to September 2006. Methods: 88 patients of multinodular thyroiddisease were included. Patients having evidence of recurrent laryngeal nerve damage, recurrentgoitre, evidence of altered parathyroid functions or evidence of malignancy were excluded. Allpatients underwent total thyroidectomy by the same team of surgeons and the patients were closelyfollowed up for postoperative complications especially in terms of recurrent laryngeal nerve damageand hypocalcaemic tetany. Results: No major postoperative complication was noted. Only 1 patient(1.14%) developed unilateral recurrent laryngeal nerve damage and 2 patients (2.27%) developedtransient hypocalcaemia that recovered quickly. Conclusion: Total thyroidectomy as a primaryelective procedure in multinodular thyroid disease is a safe option and it removes the disease processcompletely, lowers local recurrence rates and avoids the substantial risks of reoperative surgery.Keywords: Multinodular goitre, Total thyroidectomy, Primary elective total thyroidectomy.References
Rosto L, Avenia N, De Palma M, Gulino G, Nasi PG, Pezzulo
L. Complications of total thyroidectomy; Incidence, preventin
and treatment. Chir Ital 2000;54:635–42.
Delbridge L, guinea AL, Reeve TS. Total thyroidectomy for
bilateral benign multinodular goiter. Effect of changing
practice. Arch Surg 1999;134:1389–93.
Giles Y, Boztepe H, Terzioglu T, Tezelman S. The advantage
of total thyroidectomy, to avoid reoperation for incidental
thyroid cancer in multinodular goiter. Arch Surg
;139:179–82.
Guraya S Y, Imran A, Khalid K. Morbidity of thyroidectomy.
Ann King Edward Med College 2000;6(4):427–30.
Kebebew E. Near-total thyroidectomy could be the best
treatment for thyroid disease in endemic regions. Invited
critique. Arch Surg 2004;139:444–7.
Russell John Howard. In: John C Watkinson, Mark N Gaze,
Janet A Wilson, (editors). Stell and Maran’s Head and Neck
Surgery. Oxford: Butterworth Heinemann; 2000.p. 469–73.
Bron LP, O'Brien CJ. Total thyroidectomy for clinically benign
disease of the thyroid gland. Br J Surg 2004;91:569–74.
Ozbas S, Kocak S, Aydintug S, Cakmak A, Demirkiran MA,
Wishart GC. Comparison of the complications of subtotal, near
total and total thyroidectomy in the surgical management of
multinodular goitre. Endocr J 2005;52:199–205.
Chaudhary IA, Afridi ZD, Samiullah , Masood R, Mallhi AA.
To ligate or not the inferior thyroid artery to avoid
hypocalcaemia after thyroid surgery. J Ayub Med Coll
Abbottabad 2007;19(2):19–22.
Watters DA, Wall J. Thyroid surgery in the tropics. ANZ J
Surg 2007;77:933–40.
Hedley AJ, Bewsher PD, Jones SJ, Khir AS, Clements P,
Matheson NA, Gunn A. Late onset hypothyroidism after
subtotal thyroidectomy for hyperthyroidism: implications for
long term follow-up. Br J Surg 1983;70:740–3.
Gibelin H, Sierra M, Mothes D, Ingrand P, Levillain P, Jones
C, Hadjadj S, Torremocha F, Marechaud R, Barbier J, Kraimps
JL. Risk factors for recurrent nodular goiter after
thyroidectomy for benign disease: case-control study of 244
patients. World J Surg 2004;28:1079–82.
Lefevre JH, Tresallet C, Leenhardt L, Jublanc C, Chigot JP,
Menegaux F. Reoperative surgery for thyroid disease.
Langenbecks Arch Surg 2007;392:685–91.
Downloads
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
