Evaluation of the Total Thyroidectomy in Treatment of Bilateral Benign Thyroid Disease

Abstract

Background and aim: Total thyroidectomy has been the treatment of choice for patients with malignant thyroid disease. However, the efficacy and safety of this procedure for patients with benign disease is still a matter of debate. The aim of this study was to evaluate safety and efficacy of total thyroidectomy in treatment of bilateral benign thyroid disease.Methods: A total of 60 patients underwent total thyroidectomy between January 2013 and May 2014 at General Surgery Department in Tanta University Hospital. Patients with thyroid cancer or suspicion of thyroid malignancy were excluded. Type of benign disease, cancer incidence (histopathological surprise), complication rates, and local recurrence rate in the follow-up period were evaluated.Results: Diagnoses before surgery were; Euthyroid multinodular goitre (n = 42, 70%), Graves disease (n = 11, 18.2%), toxic multinodular goitre (n = 5, 8.3%), and recurrent goitre (n = 2, 3.4%). Temporary unilateral recurrent laryngeal nerve palsy occurred in one patient (1.7%). We observed no temporary or permanent bilateral recurrent laryngeal nerve injury. Temporary hypocalcemia occurred in 5 patients (8.3%) with no permanent hypocalcemia. Postoperative seroma occurred in one patient (1.7%). There was no postoperative hemorrhage, infection or mortality. During the follow-up period, we observed no disease recurrence.Conclusion: Total thyroidectomy is safe and is associated with a low incidence of disabilities, recurrent laryngeal nerve palsy and hypoparathyroidism. Furthermore, it seems to be the optimal procedure, when surgery is indicated, for Graves disease and multinodular goitre, as total thyroidectomy has the advantages of immediate and permanent cure and no recurrences. It also eliminates the requirement of completion thyroidectomy for incidentally diagnosed thyroid carcinoma.