[Total thyroidectomy in iodine-deficient goiter--an effective treatment alternative?]

It can be difficult to define the extent of struma resection because of large multinodular transformation. The total thyroidectomy of goiter is refused due to a supposed increase in complications. A high rate of goiter recurrence together with higher risks of complications demonstrates the problems of insufficient resection. This study investigates the rate of complications of total thyroidectomy of goiter. 4767 surgical treatments (partial thyroidectomy, hemithyroidectomy or total thyroidectomy) of goiter were investigated. Retrospectively the rate of postoperative complications (hemorrhage, wound infection, recurrent nerve palsy, hypocalcemia) after strumectomy or hemithyroidectomy was analysed in our patients and compared with the data of the literature. Total thyroidectomy (n = 176) did not cause a higher rate of complications (hemorrhage: 0.6%, hypocalcemia: 0.6%; recurrent nerve palsy: 0.6%) compared to the control group and the literature. Thus, total thyroidectomy can offer an efficient therapeutic option in large multinodular goiter.