Is hemithyroidectomy a rational management for benign nodular goitre? A Multicentre Retrospective Single Group Study.

Area of Science:

• Endocrinology
• Thyroid Surgery
• Surgical Outcomes

Background:

• Recurrence rates and risk factors for benign nodular goitre post-unilateral thyroidectomy are not well-established.
• Understanding long-term outcomes is crucial for patient management.

Purpose of the Study:

• To evaluate the progression rate of nodular goitre in the remaining thyroid lobe after hemithyroidectomy.
• To determine the incidence of hypothyroidism requiring L-thyroxine (L-T4) replacement therapy.
• To identify clinical factors influencing goitre progression.

Main Methods:

• Retrospective analysis of 259 patients undergoing hemithyroidectomy for benign nodular goitre (2000-2009).
• Primary outcomes: reoperation for recurrent goitre, goitre progression, and hypothyroidism requiring L-T4.
• Analysis of clinical factors affecting goitre progression.

Main Results:

• Goitre progression in the remnant lobe occurred in 32% of patients.
• Only 2% of those with progression required contralateral hemithyroidectomy.
• Persistent hypothyroidism necessitating L-T4 replacement was observed in 22% of patients.
• Factors associated with progression included advanced age, preoperative hyperthyroidism, and toxic nodular goitre diagnosis.

Conclusions:

• Approximately one-third of patients experience nodular goitre progression after hemithyroidectomy.
• Clinical progression requiring completion thyroidectomy is uncommon (2%).
• A significant proportion of patients develop hypothyroidism requiring long-term L-T4 therapy.