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World Journal of Surgery

Published in:

01-07-2008

Subtotal and Near Total Versus Total Thyroidectomy for the Management of Multinodular Goiter

Authors: Michael Vaiman, Andrey Nagibin, Philippe Hagag, Alexey Buyankin, Julian Olevson, Nathan Shlamkovich

Published in: World Journal of Surgery | Issue 7/2008

Abstract

Background

The purpose of the present work was to compare rates of postsurgical complications following thyroidectomy for multinodular goiter through a retrospective multicenter cohort study.

Methods

All cases of thyroidectomy (total—TT; near total—NT; and bilateral subtotal—ST) performed in two hospitals from 1990 to 2005 were studied to determine the incidence of complications after each procedure. Follow-up checked injury of laryngeal nerves, hypoparathyroidism, hypothyroidism, pathology recurrence, and appearance of neoplasm.

Results

There were 6,223 cases: TT, n = 3,834 (61.6%); ST, n = 2,238 (36%); and NT, n = 151 (2.4%) NT). Of this total, 2,758 (44.3%) patients were men and 3,465 (55.7%) were women with a mean age of 48.7. Postoperative mean follow-up was 7 years, 2 months. Permanent recurrent laryngeal nerve (RLN) injury was observed in 1.4% in the TT group, 1.2% in the ST group, and 1.1% in the NT group (p > 0.1). Permanent hypocalcemia was observed in 2% in TT group, 1.9% in the ST group, and 2% in the NT group (p > 0.1). Permanent hypothyroidism occurred in all patients in the TT and NT groups, compared to 91% of the patients in the ST group (p > 0.1). Recurrence of benign disease was noted in 491 patients (20.5% of ST and NT cases combined; p < 0.05), n = 482 (21.5%) after ST and n = 9 (5.9%) after NT. Of the patients with recurrence, 173 needed a completion thyroidectomy. Malignant transformation was observed in 28 cases.

Conclusions

There is no statistically significant difference in complications among TT, NT, and ST groups. Partial thyroidectomies provide no decisive advantage over total thyroidectomies in terms of subsequent requirements of supplemental hormone therapy. The rate of reoperation in cases of recurrent pathology and incidental carcinoma was high.

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Title: Subtotal and Near Total Versus Total Thyroidectomy for the Management of Multinodular Goiter
Authors: Michael Vaiman
Andrey Nagibin
Philippe Hagag
Alexey Buyankin
Julian Olevson
Nathan Shlamkovich
Publication date: 01-07-2008
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 7/2008
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-008-9541-9

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Subtotal and Near Total Versus Total Thyroidectomy for the Management of Multinodular Goiter

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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