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Related Experiment Videos

[Nearly total thyroidectomy: versus total thyroidectomy: our experience].

G Candela1, S Varriale, L Di Libero

  • 1VII Divisione di Chirurgia Generale, Seconda Università degli Studi di Napoli, Napoli, Italy.

Minerva Chirurgica
|March 29, 2006
PubMed
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Near total thyroidectomy offers a safer alternative to total thyroidectomy for benign thyroid conditions, reducing risks of permanent hypoparathyroidism and laryngeal nerve paralysis. This approach is recommended when malignancy is excluded.

Area of Science:

  • Endocrine Surgery
  • Thyroid Pathology
  • Surgical Outcomes

Background:

  • Thyroidectomy is a common surgical procedure for various benign thyroid conditions, including multinodular goitre, simple goitre, toxic adenoma, Graves' disease, and Hashimoto's thyroiditis.
  • Near total thyroidectomy, involving removal of most of the thyroid gland leaving less than 5 grams, has largely replaced subtotal thyroidectomy (leaving 6-10 grams).

Purpose of the Study:

  • To evaluate and compare the outcomes of near total thyroidectomy versus total thyroidectomy for benign thyroid pathologies.
  • To assess the incidence of complications such as haemorrhage, hypoparathyroidism, and recurrent laryngeal nerve paralysis associated with these surgical techniques.

Main Methods:

  • A retrospective review of thyroidectomy procedures performed over a two-year period.

Related Experiment Videos

  • Surgical procedures included 96 near total thyroidectomies, 96 total thyroidectomies, and 8 lobectomies, with two reoperations for recurrent disease.

    • Main Results:

    • Near total thyroidectomy resulted in no permanent vocal cord paralysis, while total thyroidectomy had a 4% incidence. Temporary paralysis occurred in 4.2% of near total and 10.4% of total thyroidectomies.
    • Permanent hypoparathyroidism occurred in 0% of near total thyroidectomies versus 4.2% for total thyroidectomies. Temporary hypoparathyroidism was observed in 4.2% of near total and 8.3% of total thyroidectomies.
    • Haemorrhage occurred in 2.1% of near total thyroidectomies. Tracheotomy was required in one case of follicular carcinoma with thyroid cartilage infiltration.

    Conclusions:

    • Near total thyroidectomy demonstrates a favorable safety profile, with a significantly lower risk of permanent hypoparathyroidism and no permanent vocal cord paralysis compared to total thyroidectomy.
    • For benign thyroid disease, a more conservative surgical approach like near total thyroidectomy is justified, especially when malignant pathology is ruled out, considering low recurrence rates and hypothyroidism effects.