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Total thyroidectomy. The preferred option for multinodular goiter.

T S Reeve1, L Delbridge, A Cohen

  • 1Department of Surgery, University of Sydney at Royal North Shore Hospital, Australia.

Annals of Surgery
|December 1, 1987
PubMed
Summary
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Total thyroidectomy is increasingly preferred for managing multinodular goiter. This approach for diffuse goiter effectively prevents disease recurrence, with low complication rates when performed carefully.

Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Thyroid Surgery

Background:

  • Total thyroidectomy was historically reserved for differentiated thyroid carcinoma.
  • Increasingly, total thyroidectomy is utilized for benign multinodular goiter.
  • The authors' unit now prefers total thyroidectomy for diffuse multinodular goiter.

Purpose of the Study:

  • To evaluate the increasing use and outcomes of total thyroidectomy for multinodular goiter.
  • To assess the safety and efficacy of total thyroidectomy in managing diffuse multinodular goiter.
  • To compare complication rates between total and subtotal thyroidectomy for multinodular goiter.

Main Methods:

  • Retrospective analysis of 853 thyroidectomies performed for multinodular goiter between 1975 and 1985.

Related Experiment Videos

  • Specific review of 115 total thyroidectomies performed for multinodular goiter during the study period.
  • Analysis of complication rates, including permanent hypoparathyroidism and recurrent laryngeal nerve injury.

    • Main Results:

    • The incidence of total thyroidectomy for multinodular goiter rose from 9% in 1975 to 50% in 1985.
    • Complications of permanent hypoparathyroidism and recurrent laryngeal nerve injury occurred in patients undergoing less than total thyroidectomy.
    • Total thyroidectomy for diffuse multinodular goiter precluded the need for reoperation due to recurrence.

    Conclusions:

    • Total thyroidectomy is an appropriate surgical option for diffuse multinodular goiter involving the entire gland.
    • This approach minimizes the risk of disease recurrence and subsequent high-risk surgeries.
    • Prioritizing recurrent laryngeal nerve and parathyroid gland protection remains critical, even in benign thyroid disease management.