Total Thyroidectomy for Management of Benign Multinodular Goitre in an Endemic Region: Review of 620 Case

The aim of this study was to evaluate the safety and efficiency of total thyroidectomy (TT) when performed by an experienced surgeon in benign multinodular goitre (BMNG) in an endemic region.

A total of six hundred and twenty consecutive patients, who underwent a total thyroidectomy for BMNG between July 2004 and May 2012, were reviewed in this study.

Of the one hundred and nine men and 511 women examined, the mean ± SD (standard deviation) ages were 48 ± 14 in men (range: 19-79) and 51 ± 16 in women (range: 18-84 years). The annual mean number of operation was 80 ± 14 (range: 68-86). The mean operation time lasted 64 ± 12 minutes (range: 48-95). About 2.3 ± 0.4 (range: 1-4) parathyroid glands were observed during thyroidectomy. Parathyroid auto transplantation was performed in seventy-eight patients (12.5%). Patient-stay in hospital was approximately 2.3 ± 0.3 days (range: 1-5). TT was performed in all patients as the primary operation. Pathologic findings revealed BMNG in four hundred and seventy (75.8%) cases, papillary carcinoma in 66 (10.3%), thyroiditis in 59 (9.5%), follicular carcinoma in 10 (1.6%), follicular adenoma in 5 (0.8%), and thyroid lymphoma in 3 cases (0.5%). Postoperatively, bilateral recurrent laryngeal nerve (RLN) injury was seen in one case (0.3%) and unilateral RLN injury in 5 (0.8%) cases. Three months later, only three cases (0.5%) were permanent. The histological diagnosis in all patients with permanent RLN injury was thyroiditis. Transient hypoparathyroidism was found in forty-eight cases (7.8%), three of which (0.5%) were permanent. Four cases were re-operated due to re-bleeding (0.6%). Seroma developed in three cases (0.5%) and wound infection in two (0.3%).

TT can be performed safely by an experienced surgeon with a minimal risk in a high volume hospital.