[Benign thyroid disease: 20-year experience in surgical therapy]

Area of Science:

• Endocrinology
• Surgical Oncology
• General Surgery

Background:

• Benign thyroid disease management often involves surgical intervention.
• Recurrence and postoperative complications are key concerns in thyroid surgery.
• Comparing different surgical extents is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare recurrence and complication rates between less radical (isthmo-lobectomy, subtotal thyroidectomy) and more radical (near-total, total thyroidectomy) surgical approaches for benign thyroid disease.
• To evaluate the efficacy of different thyroidectomy techniques in preventing disease recurrence.
• To assess the incidence of temporary hypocalcemia associated with each surgical method.

Main Methods:

• Retrospective study of 202 patients with benign thyroid disease operated on between 1988 and 1998.
• Patients were divided into two groups: Group I (isthmo-lobectomy/subtotal thyroidectomy) and Group II (near-total/total thyroidectomy).
• Follow-up ranged from 1 to 10 years to assess recurrence and complication rates.

Main Results:

• The recurrence rate was significantly lower in Group II (0%) compared to Group I (14.4%) (p = 0.000064).
• Temporary hypocalcemia was significantly higher in Group II (29%) than in Group I (2.2%) (p = 0.000001).
• Within Group II, total thyroidectomy had a higher rate of temporary hypocalcemia (37.7%) than near-total thyroidectomy (15.4%) (p = 0.0013).

Conclusions:

• Near-total and total thyroidectomy are effective in preventing recurrence of benign thyroid disease.
• While more radical surgeries increase the risk of temporary hypocalcemia, this can be managed with careful surgical technique.
• Near-total thyroidectomy may offer a balance between recurrence prevention and reduced complication rates.