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Related Concept Videos

Hyperthyroidism I: Introduction01:25

Hyperthyroidism I: Introduction

Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...
The Thyroid Gland01:23

The Thyroid Gland

The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
Goiter01:27

Goiter

Goiter refers to an abnormal enlargement of the thyroid gland that may appear as a diffuse goiter (uniform enlargement) or nodular (single or multiple nodules). Functionally, it is classified as nontoxic (normal/low hormone levels) or toxic (excess hormone production).PathophysiologyDiffuse thyroid enlargement typically results from prolonged stimulation by thyroid-stimulating hormone (TSH) or TSH-like agents, commonly seen in hypothyroidism or iodine deficiency. In contrast, in hyperthyroid...
Graves' Disease I: Introduction01:28

Graves' Disease I: Introduction

Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence in...
Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...
Graves Disease II: Pathophysiology01:24

Graves Disease II: Pathophysiology

Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...

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Related Experiment Video

Updated: May 28, 2026

Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
05:12

Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy

Published on: May 12, 2023

Total thyroidectomy for benign thyroid disease: is it really worthwhile?

Marcin Barczyński1, Aleksander Konturek, Małgorzata Stopa

  • 1Department of General Surgery, Jagiellonian University, Medical College, Kraków, Poland. marbar@mp.pl

Annals of Surgery
|October 19, 2011
PubMed
Summary

Bilateral subtotal thyroidectomy (BST) for benign goiter has higher rates of completion thyroidectomy and recurrent goiter requiring reoperation compared to total thyroidectomy (TT). Permanent complications were similar between BST and TT procedures.

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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
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Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
04:01

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

Published on: September 15, 2023

Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Thyroid Surgery

Background:

  • Surgical management of benign bilateral thyroid disease (BBTD) remains debated.
  • Total thyroidectomy (TT) offers potential advantages like single-stage incidental cancer removal and reduced recurrence.
  • These benefits must be weighed against potential surgical morbidity.

Purpose of the Study:

  • To compare surgical outcomes of bilateral subtotal thyroidectomy (BST) versus total thyroidectomy (TT) for benign bilateral thyroid disease (BBTD).
  • To evaluate the rates of incidental thyroid cancer, recurrent goiter, completion thyroidectomy, and surgical morbidity.
  • To assess the impact of surgical extent on permanent complications.

Main Methods:

  • Retrospective cohort study of 8032 patients with BBTD.
  • Group A: BST (n=5214, 1999-2004).
  • Group B: TT (n=2918, 2005-2009).
  • Prospective data collection and analysis of outcomes including incidental cancer, recurrence, completion thyroidectomy, and morbidity.

Main Results:

  • Incidental thyroid cancer prevalence was 5.00%.
  • BST required completion thyroidectomy in 2.15% of cases versus 0.10% for TT (P < 0.001).
  • Recurrent goiter requiring reoperation occurred in 45.33% after BST versus 0% after TT (P < 0.001).
  • Transient hypoparathyroidism was higher in BST (2.70%) vs TT (13.12%) (P < 0.001).
  • Permanent hypoparathyroidism and recurrent laryngeal nerve (RLN) injury rates were similar between BST and TT.

Conclusions:

  • Bilateral subtotal thyroidectomy (BST) is associated with significantly higher rates of completion thyroidectomy and reoperation for recurrent goiter compared to total thyroidectomy (TT).
  • The extent of thyroid resection (BST vs. TT) did not significantly impact the rates of permanent hypoparathyroidism or recurrent laryngeal nerve injury.
  • TT may be preferred for benign bilateral thyroid disease due to lower recurrence and need for reoperation.