Safety and Effectiveness of Total Thyroidectomy for Benign Multinodular Goitre

• Naser Musbah

  Department of surgery, Faculty of Medicine OMU, Al Beida, Libya

  Author

• Hasan I. Fadel Saad

  Department of surgery

  Author

• Salma Saleh Mohamed

  Department of Surgery, Faculty of Medicine, Omar Al Mukhtar University, El Beida, Libya

  Author

Total thyroidectomy is considered the best choice for thyroids carcinoma. However, it is still controversial for benign thyroid diseases because of higher complication rates. But meticulous surgical techniques by expert surgeons can avoid most of the complications and thereby avoid the risk of reoperation for any recurrences. The objective of the study was to evaluate and justify the use of total thyroidectomy in benign thyroid diseases especially in multinodular goiter and Grave’s disease. We have carried out an ongoing prospective study of thyroidectomy cases for different indications over a span of 5 years, from 2012 to 2016; in the Surgery department, Al-Thowra teaching hospital, Al-Beida. The total number of operated cases was 353. Cases were distributed according to age, sex, diagnosis and operative procedures. Various complications encountered were enlisted. Total thyroidectomy was performed in 247 cases for MNG and Thyroid malignancy. Hemi-thyroidectomy or lobectomy was done in 82 cases for solitary nodules. Enucleation of cysts was done in 6 cases. Operations were done for recurrent nodules in 18 cases. Overall complications were few and only minor. We recommend total thyroidectomy for all cases of MNG; which will reduce the risk of recurrence and development of malignancy in residual thyroid tissue. It also can prevent secondary thyrotoxicosis.

Agarwal, G., & Aggarwal, V. (2008). Is total thyroidectomy the surgical procedure of choice for benign multinodular goiter? An evidence-based review. World journal of surgery, 32(7), 1313.

Cirocchi, R., Trastulli, S., Randolph, J., Guarino, S., Di Rocco, G., Arezzo, A., D'Andrea, V., Santoro, A., Barczynski, M., & Avenia, N. (2015). Total or near‐total thyroidectomy versus subtotal thyroidectomy for multinodular non‐toxic goitre in adults. Cochrane Database of Systematic Reviews(8).

Efremidou, E. I., Papageorgiou, M. S., Liratzopoulos, N., & Manolas, K. J. (2009). The efficacy and safety of total thyroidectomy in the management of benign thyroid disease: a review of 932 cases. Canadian Journal of Surgery, 52(1), 39.

Gangappa, R. B., Kenchannavar, M. B., Chowdary, P. B., Patanki, A. M., & Ishwar, M. (2016). Total thyroidectomy for benign thyroid diseases: What is the price to be paid? Journal of clinical and diagnostic research: JCDR, 10(6), PC04.

Mauriello, C., Marte, G., Canfora, A., Napolitano, S., Pezzolla, A., Gambardella, C., Tartaglia, E., Lanza, M., & Candela, G. (2016). Bilateral benign multinodular goiter: what is the adequate surgical therapy? A review of literature. International Journal of Surgery, 28, S7-S12.

Padur, A. A., Kumar, N., Guru, A., Badagabettu, S. N., Shanthakumar, S. R., Virupakshamurthy, M. B., & Patil, J. (2016). Safety and effectiveness of total thyroidectomy and its comparison with subtotal thyroidectomy and other thyroid surgeries: a systematic review. Journal of thyroid research, 2016.

Rosto, L., Avenia, N., De Palma, M., Gulino, G., Nasi, P., & Pezzulo, L. (2000). Complications of total thyroidectomy; Incidence, preventin and treatment. Chir Ital, 54(5), 635-642.

Tezelman, S., Borucu, I., Senyurek, Y., Tunca, F., & Terzioglu, T. (2009). The change in surgical practice from subtotal to near-total or total thyroidectomy in the treatment of patients with benign multinodular goiter. World journal of surgery, 33(3), 400.

Thomusch, O., Machens, A., Sekulla, C., Ukkat, J., Brauckhoff, M., & Dralle, H. (2003). The impact of surgical technique on postoperative hypoparathyroidism in bilateral thyroid surgery: a multivariate analysis of 5846 consecutive patients. Surgery, 133(2), 180-185.

Yang, W., Shao, T., Ding, J., Jin, X., Li, Q., Chu, P. G., Yen, Y., & Qiu, W. (2009). The feasibility of total or near-total bilateral thyroidectomy for the treatment of bilateral multinodular goiter. Journal of Investigative Surgery, 22(3), 195-200.

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