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Total thyroidectomy for bilateral benign multinodular goiter: effect of changing practice.
L Delbridge1, A I Guinea, T S Reeve
1Department of Surgery, Royal North Shore Hospital, University of Sydney, Australia. leighd@med.usyd.edu.au
Archives of Surgery (Chicago, Ill. : 1960)
|December 11, 1999
Summary
Total thyroidectomy is now the standard treatment for bilateral benign multinodular goiter in Australia and New Zealand. This shift has reduced the need for repeat surgeries for recurrent goiter.
Area of Science:
- Endocrine Surgery
- Surgical Oncology
- Thyroid Disease Management
Background:
- Bilateral benign multinodular goiter (BMNG) management has evolved.
- Historically, subtotal thyroidectomy was common for BMNG.
- The shift towards total thyroidectomy aimed to improve patient outcomes and reduce recurrence.
Purpose of the Study:
- To assess if a single institution's shift to total thyroidectomy for BMNG influenced regional practice.
- To document the changing trends in thyroidectomy procedures for BMNG in Australia and New Zealand.
Main Methods:
- A 40-year retrospective analysis of thyroidectomy for BMNG at a single institution.
- A mail survey of 75 endocrine surgeons in Australia and New Zealand regarding their BMNG surgical practices.
- Analysis of procedure incidence and trends over time.
Main Results:
- The institution shifted from subtotal to total thyroidectomy in 1984; 94% of BMNG cases are now treated with total thyroidectomy.
- Secondary thyroidectomies for recurrent goiter initially increased but are now declining.
- 60% of surgeons in Australia and New Zealand now prefer total thyroidectomy for BMNG.
Conclusions:
- Total thyroidectomy is a safe and effective treatment for BMNG.
- Total thyroidectomy has become the routine procedure for BMNG in Australia and New Zealand.
- Increased use of total thyroidectomy correlates with a decreased need for secondary thyroidectomy.