Total Thyroidectomy versus Subtotal Thyroidectomy as a Suitable Surgery for Benign Thyroid Disorders

Area of Science:

• Endocrine Surgery
• Surgical Oncology
• Thyroidology

Background:

• Thyroid disease management involves various surgical options including lobectomy, subtotal thyroidectomy (STT), and total thyroidectomy (TT).
• Benign thyroid disorders necessitate surgical intervention when conservative measures fail or complications arise.

Purpose of the Study:

• To compare the complication rates of total thyroidectomy (TT) versus subtotal thyroidectomy (STT) in patients with bilateral benign thyroid disorders.
• To evaluate operative time, hospital stay, and long-term outcomes including recurrence and incidental malignancies for both surgical approaches.

Main Methods:

• A comparative study involving sixty patients with benign goiter.
• Thirty-two patients underwent total thyroidectomy (TT), and twenty-eight patients underwent subtotal thyroidectomy (STT).
• Data collected included indications for surgery, operative time, hospital stay, and postoperative complications.

Main Results:

• Transient recurrent laryngeal nerve (RLN) palsy occurred in 6.25% of TT patients and 3.57% of STT patients.
• Temporary hypoparathyroidism was observed in 9.38% of TT patients versus 7.14% of STT patients.
• Permanent complications were rare, with one case of permanent RLN palsy and hypoparathyroidism in the TT group; no permanent complications occurred in the STT group. Goiter recurrence was noted in 7.14% of STT patients, and incidental malignancies were found in both groups.

Conclusions:

• Total thyroidectomy (TT) is a suitable surgical option for bilateral benign thyroid disease, demonstrating comparable complication rates, operative time, and hospital stay to subtotal thyroidectomy (STT).
• TT provides a definitive cure, eliminating the risk of goiter recurrence.
• TT also allows for the detection and management of incidental thyroid malignancies, which may be missed with STT.