Comparison of the early complications of total and subtotal thyroidectomy in the multinodular goitre
Cemalettin Durgun, Abdullah Böyük, Sadullah Girgin, Murat Kapan, Akın Önder, Metehan Gümüş, İbrahim Halil Taçyıldız
Dicle Üniversitesi Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Diyarbakır, Türkiye
Abstract
Purpose: In the recent years, total thyroidectomy is increasingly being accepted in the surgical treatment of benign multinodular goitre due to the high rate of recurrence after bilateral subtotal thyroidectomy. The aim of this study is to compare early postoperative complications of total and bilateral subtotal thyroidectomy in benign multinodular goitre.
Materials and Methods: In our study, the findings of 419 patients operated due to multinodular goitre between January 2005 - December 2009 in Dicle University Medical School Department of General Surgery were retrospectively evaluated. Patients were divided into two groups as total thyroidectomy and bilateral subtotal thyroidectomy.
Results: The mean age of patients was 41.72 ± 12.55. 329 (78.5%) patients were women and 90 (21.5%) were men. A total of 263 (62.8%) patients underwent total and 156 (37.2%) patients bilateral subtotal thyroidectomy. Six (2.3%) of total thyroidectomy patients and 3 (1.9%) of bilateral subtotal thyroidectomy patients had recurrent laryngeal nerve injury. Bilateral subtotal thyroidectomy group revealed no permanent damage whereas in total thyroidectomy group one (0.4%) patient did. Hypocalcemia was observed in 40 (15.2%) patients in the total thyroidectomy group and in 27 (17.3%) patients in the bilateral subtotal thyroidectomy group. One (0.4%) patient in total thyroidectomy group suffered from permanent hypocalcemia whereas it wasn't observed in bilateral subtotal thyroidectomy group. Haematoma occurred in 3 (1.9%) patients treated with bilateral subtotal thyroidectomy and in 3 (1.1%) treated with total thyroidectomy, wound infection occured in one (0.6%) patient subjected to bilateral subtotal thyroidectomy and 3 (1.1%) patients treated with total thyroidectomy.
Conclusion: In conclusion, our study supports total thyroidectomy for multinodular goitre involving both lobes as a safe technique with low complication rate.
Keywords: Multinodular goitre, total thyroidectomy, subtotal thyroidectomy