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Updated: Apr 16, 2026
Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
Published on: September 20, 2024
A Conservative Approach Is Reasonable in Patients with Non-Toxic Goitre: Results from an Observational Study during
Johannes Järhult1, Ramtin Vedad2
1Department of Surgery, Highland Hospital, Eksjö, Jönköping, Sweden ; Department of Surgery, County Hospital Ryhov, Jönköping, Sweden.
Background:
There is a lack of consensus in Europe regarding the management of patients with benign goitre. The object of this study was to find out the long-term results of recommending to patients with clinically and cytologically benign non-toxic goitres not to be operated.
Methods:
980 patients were initially referred for surgical evaluation due to non-toxic goitre, 508 of whom underwent directly thyroidectomy. The remaining 473 patients (median age 56 years) were not operated and followed prospectively for a median period of 145 months.
Results:
During follow-up, 38% of the 473 patients were re-referred to the surgeon for a new evaluation due to different complaints, mainly growth of the goitre and/or worsening of local symptoms. 102 of the 473 patients (22%) had surgery and 27 (5.7%) developed thyrotoxicosis. 14 patients (3%) were diagnosed with thyroid carcinoma, 4 (0.46%) of whom (all elderly women) died of the disease.
Conclusions:
In patients with non-toxic goitre in whom surgery is not deemed necessary at initial evaluation, a conservative approach is reasonable. There is, however, a small risk for the development of aggressive carcinomas, and a fourth of the patients are operated at a median follow-up of 12 years.
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