Total Thyroidectomy for Bilateral Benign Multinodular Goiter

Delbridge, Leigh; Guinea, Ana I.; Reeve, T. S.

doi:10.1001/archsurg.134.12.1389

Cited by 181 publications

(177 citation statements)

References 13 publications

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“…Delbridge et al state that transient hypoparathyroidism should be an accepted outcome of bilateral thyroid surgery rather than a complication [23]. It is noted that the degree and duration of hypoparathyroidism increase with the extent of thyroid surgery [24].…”

Section: Discussionmentioning

confidence: 99%

The Factors Related with Postoperative Complications in Benign Nodular Thyroid Surgery

et al. 2010

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Thyroid gland is an important endocrine organ because of its functions. Although the morbidity and mortality of thyroid surgery have decreased markedly, serious complications may still occur. The aim of this retrospective study was to identify the factors influencing the complications in benign nodular thyroid surgery. A total of 332 patients who underwent thyroid surgery between April 2004 and May 2008 were evaluated retrospectively to identify the factors influencing the complications. We found that in surgery lasting more than 90 minutes the risk of permanent recurrent laryngeal nerve (RLN) injury was high, daily drainage more than 50 cc increases the risk of seroma formation, retrosternal goiter surgery have higher risk for bleeding. The flap edema rates were high found in the operations made by resident surgeon and patients with size 3-4 thyroid glands. Low complication rates can be achieved after thyroidectomy with better knowledge of the surgical anatomy of the neck, thyroid pathology and required surgical treatment.

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Section: Discussionmentioning

confidence: 99%

The Factors Related with Postoperative Complications in Benign Nodular Thyroid Surgery

et al. 2010

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“…It has the disadvantage of high recurrence rates and carries the risk for increased surgical morbidity during the course of re-operation [4,9,20,23]. The incidence of recurrence after subtotal thyroidectomy varies in different studies and may be as high as 23% [8,12,24]. The recurrence rate following BST is largely dependent on the length of follow-up, and has been reported as 42% in one study with thirty-year follow-up [23].…”

Section: Discussionmentioning

confidence: 99%

“…There are increasing numbers of publications recommending TT for bilateral MNG [9][10][11][12][13][14][15][16][17]. The authors who favour TT state that this operation has low complication rates in the hands of experienced thyroid surgeons [18,19] and has an incidence of iatrogenic injuries that is similar to a subtotal procedure [20,21].…”

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confidence: 99%

Comparison of the Complications of Subtotal, Near Total and Total Thyroidectomy in the Surgical Management of Multinodular Goitre

et al. 2005

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Abstract. Purpose of the study is to compare complication rates of bilateral subtotal (BST), near total (NTT) and total thyroidectomy (TT) in a cohort of patients undergoing surgery for benign multinodular goitre (MNG). Seven hundred and fifty patients undergoing surgery for MNG were studied with a median follow-up of 53 months (range 18-102). There was no operative mortality in this group and no patients required urgent re-exploration for haematoma. After BST 14 patients (14/170 -8.2%) developed transient hypocalcaemia and 4 patients (4/170 -2.4%) had transient and one permanent (1/170 -0.6%) recurrent laryngeal nevre (RLN) palsy. In NTT group 39 patients (39/320 -12.2%) developed transient hypocalcaemia and 2 patients (0.6%) transient voice disturbances. None of the patients in this group experienced permanent complications. However, in TT group 78 patients had (78/260 -30%) transient hypocalcaemia whereas only one patient (1/260 -0.4%) suffered permanent hypoparathyroidism and 5 patients (5/260 -1.9%) had temporary RLN injury but none of them remained permanent. There are only 2 (2/170 -1.2%) recurrences and those patients are in BST group. All of the patients in BST group required at least 100 mg of thyroxine supplementation following the operation. These results demonstrate low permanent complication rates following thyroid surgery. Although the incidence of transient hypoparathyroidism increases with the extent of the resection, permanent complication rates are similar for all three surgical procedures. Even with short follow-up, there is a risk of recurrence with BST and therefore NTT or TT may be the operation of choice for MNG.

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“…There are increasing number of reports suggesting using it for bilateral benign multinodular goiter or Graves-Basedow`s disease (3,4,5) .…”

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confidence: 99%

Total Thyroidectomy for Nodular, Benign Thyroid Diseases in Terms of Larynx Function Examinations - Is it a New Treatment Standard?

Kaczka

Jankowski

Kopczyński

et al. 2010

Polish Journal of Surgery

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Aim of the study was the assessment of total thyroidectomy (TT) value as a treatment method of goiter with particular emphasis on the results of laryngological examination. material and methods. From 15 th April 2008 to 1 st July 2009 there were 125 (72.7%) TTs, 12 (7%) TTs and appropriate lymphadenectomies, 9 (5.2%) near TTs, 14 (8.1%) lobectomies, 5 (2.9%) completion thyroidectomies and 6 (3.4%) other operations. Vocal cords function was assessed routinely one day before, two days after operation by an otolaryngologist. Voice quality was assessed by patients in VHI questionnaire theirselves. Results. Five patients had one-sided vocal cord paralysis before the operation. The one-sided transient recurrent laryngeal nerve injuries was observed in 16 other patients (9.3% among patients and 4.6% among nerves at risk)in the second day after the operation. There was no bilateral recurrent laryngeal nerve injury. From three to six months after the operation, 21 (among 23) patients with vocal cord movement disability were examined once again by the same otolaryngologist. The same vocal cord paralysis was observed in 4 sicks (one person died), which was found preoperatively. Seven (4%) other patients had permanent one vocal cord paresis. This represents 2% the nerves at risk. Three of them were recognized benign lesions and four thyroid cancer. Our percentage of early, postoperative hypoparathyroidism was 6.4% and persistent was 1.7%. VHI score in the group with paresis or paralysis of vocal cord gave the score of 4 to 90 points-an average of 49 points. In patients with proper vocal cord movement there were results from 0 to 6 points-an average of 2 points. conclusions. 1. Total thyroidectomy in the treatment of bilateral goiter without malignancy features is radical and safe procedure. 2. It protects against goiter relapse and its consequences. 3. Complications rates after total thyroidectomy are at acceptable and comparable proportions to the other operation types.

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Total Thyroidectomy for Bilateral Benign Multinodular Goiter

Cited by 181 publications

References 13 publications

The Factors Related with Postoperative Complications in Benign Nodular Thyroid Surgery

The Factors Related with Postoperative Complications in Benign Nodular Thyroid Surgery

Comparison of the Complications of Subtotal, Near Total and Total Thyroidectomy in the Surgical Management of Multinodular Goitre

Total Thyroidectomy for Nodular, Benign Thyroid Diseases in Terms of Larynx Function Examinations - Is it a New Treatment Standard?

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