Changes in the choice of thyroidectomy for benign thyroid disease

Area of Science:

• Endocrinology
• Surgical Oncology
• Thyroid Surgery

Background:

• Increasing trend towards radical resections for benign thyroid disease.
• Shift in surgical practice from subtotal to more radical thyroidectomy procedures.
• Need to evaluate the impact of this trend on bilateral thyroid disease treatment.

Purpose of the Study:

• To examine the effect of the trend towards radical resections on surgical treatment for bilateral thyroid diseases.
• To compare the outcomes of different thyroidectomy types for bilateral benign thyroid conditions.

Main Methods:

• Retrospective analysis of 367 patients undergoing bilateral thyroidectomy.
• Categorization of procedures into total thyroidectomy (TT), near-total thyroidectomy, Dunhill procedure, and bilateral subtotal thyroidectomy (STT).
• Comparison of complication and recurrence rates across different surgical approaches.

Main Results:

• A statistically significant shift in surgical choice towards TT for bilateral benign thyroid diseases.
• Permanent complication rates were comparable across all surgical procedures.
• Significantly higher rates of secondary thyroidectomy for recurrence and incidental carcinoma in STT groups compared to TT and near-total thyroidectomy.

Conclusions:

• Total or near-total thyroidectomy are increasingly favored for bilateral benign thyroid disease.
• These radical procedures are as safe as subtotal thyroidectomy.
• Subtotal thyroidectomy is associated with significantly higher recurrence rates.