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Surgical indications for toxic multinodular goitre.
Adolfo Pisanu1, Alessandro Montisci, Alessandro Cois
1Dipartimento di Chirurgia, Semeiotica Chirurgica, Università di Cagliari, Centro di Studio per la Chirurgia Endocrina e Metabolica.
Chirurgia Italiana
|October 26, 2005
Summary
Total thyroidectomy effectively treats toxic multinodular goitre, resolving hyperthyroidism and removing the goitre. Post-surgical hypothyroidism is easily managed, with no permanent complications observed in this study.
Area of Science:
- Endocrinology
- Surgical Oncology
- Thyroid Surgery
Background:
- Toxic multinodular goitre (TMG) presents challenges in management.
- Surgical intervention, specifically total thyroidectomy, is considered for TMG.
- Indications and outcomes of total thyroidectomy for TMG require clarification.
Purpose of the Study:
- To define surgical indications for total thyroidectomy in TMG.
- To evaluate the effectiveness of total thyroidectomy in treating TMG.
- To assess the safety and complication profile of total thyroidectomy for TMG.
Main Methods:
- Retrospective analysis of 70 patients undergoing total thyroidectomy for TMG.
- Data collection on indications for surgery, including compressive symptoms, cytological atypia, suspected malignancy, and treatment failures.
- Assessment of postoperative outcomes, complications, and symptom resolution.
Main Results:
- Total thyroidectomy was performed for various indications in 70 patients.
- Primary indications included compressive goitres (25), cervico-mediastinal goitres (12), and cytological atypia/suspected malignancy (7).
- Secondary indications involved treatment failure/intolerance (24), including persistent/recurrent hyperthyroidism, cardiotoxicity, and drug intolerance.
- All patients achieved symptom relief and biochemical hypothyroidism post-surgery.
- Transient hypocalcaemia (8.6%) and recurrent laryngeal nerve injury (4.2%) were observed, with no permanent sequelae.
- Mean hospital stay was 3.2 days.
Conclusions:
- Total thyroidectomy is a safe and effective treatment for toxic multinodular goitre.
- It provides rapid resolution of hyperthyroidism and removes the goitre, eliminating the need for re-treatment.
- The procedure effectively addresses compressive symptoms, suspicious nodules, and treatment failures, with manageable postoperative hypothyroidism.