Indications, Risks, and Acceptance of Total Thyroidectomy for Multinodular Benign Goiter

Müller, Peter E.; Kabus, Steffen; Robens, Elisabeth; Spelsberg, F

doi:10.1007/s005950170002

Cited by 40 publications

(13 citation statements)

References 12 publications

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“…Therefore, it is plausible that the improvement of OSA by thyroidectomy in this patient helped alleviate her nocturnal bradycardia and sinus pauses. Notably, consistent with the majority of benign goiters, the patient was euthyroid [ 13 ].…”

Section: Discussionsupporting

confidence: 57%

Symptomatic Long Pauses and Bradycardia due to Massive Multinodular Goiter

Deshmukh

Özcan

2017

Case Reports in Cardiology

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Sinus node dysfunction with symptomatic bradycardia or chronotropic incompetence is generally an indication for pacemaker implantation. However, in patients with symptomatic sinus bradycardia, the identification and treatment of underlying pathologies may avoid the need for permanent pacemaker implantation. We present a case of carotid sinus syndrome and severe obstructive sleep apnea due to a massive multinodular goiter in a patient who presented with recurrent sinus pauses and syncope. The patient was managed without pacemaker implantation but instead with thyroidectomy resulting in decompression of the carotid sinus and airway and resolution of bradycardic episodes.

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Section: Discussionsupporting

confidence: 57%

Symptomatic Long Pauses and Bradycardia due to Massive Multinodular Goiter

Deshmukh

Özcan

2017

Case Reports in Cardiology

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“…Mishra et al demonstrated an 0.8% permanent RLN rate and 1.6% permanent hypoparathyroidism rate whilst Müller et al found a 0.9% rate for both morbidities [21, 22]. Many other studies confirmed similar findings [23–25].…”

Section: Discussionmentioning

confidence: 78%

The Morbidity of Reoperative Surgery for Recurrent Benign Nodular Goitre: Impact of Previous Unilateral Thyroid Lobectomy versus Subtotal Thyroidectomy

Rudolph

Dominguez

Beaulieu

et al. 2014

Journal of Thyroid Research

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Background. Subtotal thyroidectomy (STT) was previously considered the gold standard in the surgical management of multinodular goitre despite its propensity for recurrence. Our aim was to assess whether prior STT or unilateral lobectomy was associated with increased reoperative morbidity. Methods. A retrospective analysis was conducted extracting data from our endocrine surgical database for the period from January 1991 to June 2006. Two patient groups were defined: Group 1 consisted of patients with previous unilateral thyroid lobectomy; Group 2 had undergone previous STT. Specific outcomes investigated were transient and permanent recurrent laryngeal nerve (RLN) injury and hypoparathyroidism. Results. 494 reoperative cases were performed which consisted of 259 patients with previous unilateral lobectomy (Group 1) and 235 patients with previous subtotal thyroidectomy (Group 2). A statistically significant increase relating to previous STT was demonstrated in both permanent RLN injury (0.77% versus 3.4%, RR 4.38, P = 0.038) and permanent hypoparathyroidism (1.5% versus 5.1%, RR 3.14, P = 0.041). Transient nerve injury and hypocalcaemia incidence was comparable. Conclusions. Reoperative surgery following subtotal thyroidectomy is associated with a significantly increased risk of permanent recurrent laryngeal nerve injury and hypoparathyroidism when compared with previous unilateral thyroidectomy. Subtotal thyroidectomy should therefore no longer be recommended in the management of multinodular goitre.

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“…In addition, surgical techniques for benign thyroidal disorders have improved greatly over the past several years and postoperative morbidity and mortality rates have further decreased. Life-threatening complications, such as postoperative bleeding, hematoma, compression of air passages or suffocation, can be avoided in most patients (Colak et al, 2004;Müller et al, 2001). In the light of these improvements, the value of drainage in thyroid surgery might be newly questioned.…”

Section: Resultsmentioning

confidence: 99%

Drainage after total thyroidectomy or lobectomy for benign thyroidal disorders

Çolak

Akça

Türkmenoğlu

et al. 2008

J. Zhejiang Univ. Sci. B

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Abstract:Objective: This prospective randomized clinical trial was conducted to evaluate the necessity of drainage after total thyroidectomy or lobectomy for benign thyroidal disorders. Methods: A total of 116 patients who underwent total thyroidectomy or lobectomy for benign thyroidal disorders were randomly allocated to be drained or not. Operative and postoperative outcomes including operating time, postoperative pain assessed by visual analogue scale (VAS), total amount of intramuscular analgesic administration, hospital stay, complications, necessity for re-operation and satisfaction of patients were all assessed. Results: The mean operating time was similar between two groups (the drained and non-drained groups). The mean VAS score was found to be significantly low in the non-drained group patients in postoperative day (POD) 0 and POD 1. The mean amount of intramuscular analgesic requirement was significantly less in the non-drained group. One case of hematoma, two cases of seroma and three cases of transient hypoparathyroidism occurred in the non-drained group, whereas one case of hematoma, two cases of seroma, two cases of wound infections and two cases of transient hypoparathyroidism occurred in the drained group. No patient needed re-operation for any complication. The mean hospital stay was significantly shorter and the satisfaction of patients was superior in the non-drained group. Conclusion: These findings suggest that postoperative complications cannot be prevented by using drains after total thyroidectomy or lobectomy for benign thyroid disorders. Furthermore, the use of drains may increase postoperative pain and the analgesic requirement, and prolong the hospital stay. In the light of these findings, the routine use of drains might not be necessary after thyroid surgery for benign disorders.

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Indications, Risks, and Acceptance of Total Thyroidectomy for Multinodular Benign Goiter

Cited by 40 publications

References 12 publications

Symptomatic Long Pauses and Bradycardia due to Massive Multinodular Goiter

Symptomatic Long Pauses and Bradycardia due to Massive Multinodular Goiter

The Morbidity of Reoperative Surgery for Recurrent Benign Nodular Goitre: Impact of Previous Unilateral Thyroid Lobectomy versus Subtotal Thyroidectomy

Drainage after total thyroidectomy or lobectomy for benign thyroidal disorders

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