TOTAL THYROIDECTOMY AS PRIMARY ELECTIVE PROCEDURE IN MULTINODULAR THYROID DISEASE

Authors

  • Irfan Ali Sheikh
  • Sheikh Saadat Ullah Waleem
  • Irfan Zafar Haider
  • Asna Haroon
  • Muhammad Ashfaq

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

2009-12-01

Most read articles by the same author(s)

<< < 1 2