Total Thyroidectomy versus Bilateral Subtotal Thyroidectomy for Bilateral Multinodular Nontoxic Goiter: A...

Area of Science:

• Endocrinology
• Surgical Oncology
• General Surgery

Background:

• Bilateral multinodular nontoxic goiter (BMNG) presents surgical challenges.
• Comparing total thyroidectomy (TT) and bilateral subtotal thyroidectomy (BST) is crucial for optimal patient outcomes.

Purpose of the Study:

• To assess the feasibility and safety of TT versus BST for BMNG.
• To compare complication and recurrence rates between TT and BST.

Main Methods:

• A meta-analysis of four randomized clinical trials involving 1,078 patients.
• Searched PubMed, Web of Knowledge, and Ovid for studies published between January 1990 and December 2014.
• Analyzed data on complications (hypoparathyroidism, recurrent laryngeal nerve palsy) and recurrence rates.

Main Results:

• Total thyroidectomy (TT) showed a significantly lower recurrence rate (OR = 0.04, p < 0.0001).
• TT had a higher incidence of transient hypoparathyroidism (OR = 2.59, p = 0.0002).
• No significant differences were found in recurrent laryngeal nerve palsy or permanent hypoparathyroidism.

Conclusions:

• Total thyroidectomy (TT) is a feasible and safe surgical option for BMNG.
• TT offers a reduced risk of goiter recurrence compared to BST.
• The increased risk of transient hypoparathyroidism with TT must be weighed against its benefits.