Subtotal and Near Total Versus Total Thyroidectomy for the Management of Multinodular Goiter

Abstract

There is no statistically significant difference in complications among TT, NT, and ST groups. Partial thyroidectomies provide no decisive advantage over total thyroidectomies in terms of subsequent requirements of supplemental hormone therapy. The rate of reoperation in cases of recurrent pathology and incidental carcinoma was high.

Complications in primary and completed thyroidectomy

“…[10][11][12] Our previous study on the subject also supports the TT choice. 13 Modern development in the use of anatomical landmarks (i.e., Zuckerkandl's tubercle) 14 in thyroidectomy makes TT easier to perform. Accumulating data suggest that an equal complication rate, both with RLN injury and hypocalcemia, is gained when performing a partial versus total thyroidectomy.…”

Totale Thyreoidektomie bei Knotenstruma

“…If a comparably low operative risk can be guaranteed and considering the patient's compliance, life situation and wishes, total thyroidectomy represents the optimal therapy for bilateral multinodular goiter. [50,55]. Nur 2 Publikationen beschreiben Ergebnisse prospektiv-randomisierter Studien und berichten ebenfalls über Rezidivraten nach bilateral subtotaler Resektion von 11,5% und 20% [3,42].…”

Terminal ligature of inferior thyroid artery branches during total thyroidectomy for multinodular goiter is associated with higher postoperative calcium and PTH levels

“…Postoperative transient hypocalcemia is observed in 0.4 to 26.8% of patients after subtotal thyroidectomy [1,2]. After total thyroidectomy, an even higher incidence of transient hypocalcemia has been reported in some series ranging from 24 to 45.5% [2][3][4][5].…”