Hemithyroidectomy for benign euthyroid asymmetric nodular goitre.

Area of Science:

• Endocrinology
• Surgical Oncology
• Thyroid Surgery

Background:

• Optimal surgical extent for benign euthyroid asymmetric nodular goitre (AMNG) lacks consensus.
• AMNG presents a common clinical and surgical challenge.

Purpose of the Study:

• To review the literature on AMNG regarding definition, prevalence, and surgical management.
• To evaluate the rationale, outcomes, and follow-up for hemithyroidectomy in AMNG.
• To explore revision surgery and thermal ablation for contralateral nodules post-hemithyroidectomy.

Main Methods:

• A comprehensive literature search was conducted using the PubMed engine.
• 102 articles were identified, and 36 clinically pertinent articles were selected for review.

Main Results:

• Hemithyroidectomy is a viable alternative to total thyroidectomy for select AMNG patients.
• This approach carries a lower immediate risk but a higher risk of recurrence.
• Long-term follow-up is essential, with potential need for revision surgery.

Conclusions:

• Hemithyroidectomy for AMNG is a safer alternative to total thyroidectomy in specific cases.
• This approach requires diligent lifelong follow-up due to increased recurrence rates.
• Revision thyroidectomy may be necessary for selected patients with recurrent disease.