Safety and Effectiveness of Total Thyroidectomy for Benign Multinodular Goitre

Total thyroidectomy is considered the best choice for thyroids carcinoma. However, it is still controversial for benign thyroid diseases because of higher complication rates. But meticulous surgical techniques by expert surgeons can avoid most of the complications and thereby avoid the risk of reoperation for any recurrences. The objective of the study was to evaluate and justify the use of total thyroidectomy in benign thyroid diseases especially in multinodular goiter and Grave’s disease. We have carried out an ongoing prospective study of thyroidectomy cases for different indications over a span of 5 years, from 2012 to 2016; in the Surgery department, Al-Thowra teaching hospital, Al-Beida. The total number of operated cases was 353. Cases were distributed according to age, sex, diagnosis and operative procedures. Various complications encountered were enlisted. Total thyroidectomy was performed in 247 cases for MNG and Thyroid malignancy. Hemi-thyroidectomy or lobectomy was done in 82 cases for solitary nodules. Enucleation of cysts was done in 6 cases. Operations were done for recurrent nodules in 18 cases. Overall complications were few and only minor. We recommend total thyroidectomy for all cases of MNG; which will reduce the risk of recurrence and development of malignancy in residual thyroid tissue. It also can prevent secondary thyrotoxicosis.

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Incidental Thyroid Carcinoma Diagnosed after Total Thyroidectomy for Benign Thyroid Diseases: Incidence and Association with Thyroid Disease Type and Laboratory Markers

International Journal of Endocrinology ◽

10.1155/2013/451959 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

D. Askitis ◽

E. I. Efremidou ◽

M. Karanikas ◽

A. Mitrakas ◽

G. Tripsianis ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Total Thyroidectomy ◽

Thyroid Disease ◽

Disease Type ◽

Thyroid Diseases ◽

Incidental Thyroid Carcinoma ◽

Laboratory Markers ◽

Benign Thyroid

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Association between multi nodular goitre and thyroid malignancy at a tertiary care centre

International Surgery Journal ◽

10.18203/2349-2902.isj20215136 ◽

2021 ◽

Vol 9 (1) ◽

pp. 86

Author(s):

Sreenidhi G. M. ◽

Jyothi S.

Keyword(s):

Total Thyroidectomy ◽

Histopathological Examination ◽

Tertiary Care ◽

Histopathological Analysis ◽

Multinodular Goitre ◽

Thyroid Malignancy ◽

Tertiary Care Centre ◽

Cross Sectional ◽

Nodular Goitre ◽

Occult Malignancy

Background: Over the past few decades, the incidence of thyroid cancer has dramatically increased. Thyroid malignancy in multinodular goitre is considered to be high and these occult malignancies are detected only in post operative histopathological analysis. The study helps in finding association between multinodular goitre and thyroid malignancy. Objective was to find the association between multinodular goitre and thyroid malignancy in those who underwent total thyroidectomy.Methods: A cross sectional study conducted in department of general surgery, KIMS hospital, Bangalore. The 236 randomized cases of multinodular goitre who underwent total thyroidectomy were selected. Patients underwent thorough clinical examination pre operatively and were reassessed in post-operative period following surgery. Later, histopathology report on thyroidectomy specimen of the patients were obtained. This report was considered the gold standard for the diagnosis of thyroid malignancy.Results: Occult malignancies were commoner in middle aged females. Most of the patients in the study underwent total thyroidectomy. The prevalence of thyroid malignancy in our study was found to be 7.2%. In the study, 17 incidental malignancies were papillary carcinomas. It revealed a highly significant relation between the lymphocytic thyroiditis and occult malignancy (p<0.0001)Conclusions: The prevalence of malignancy in multinodular goitre is 7.2%. The only variant of incidental malignancy detected in histopathological examination of excised thyroid was papillary carcinoma. There is a statistically significant association between presence of thyroiditis in preoperative FNA and presence of occult malignancy carcinoma.

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Is it Time to Shift to Total Thyroidectomy for Benign Thyroid Disease: An Analysis of 77 Redo Thyroidectomies

International Journal of Phonosurgery & Laryngology ◽

10.5005/jp-journals-10023-1093 ◽

2015 ◽

Vol 5 (1) ◽

pp. 4-6

Author(s):

G Raghavendra Prasad

Keyword(s):

Total Thyroidectomy ◽

Thyroid Disease ◽

Recurrent Laryngeal Nerve Palsy ◽

Benign Disease ◽

Subtotal Thyroidectomy ◽

High Rate ◽

Follicular Neoplasm ◽

Complication Rates ◽

Benign Thyroid Disease ◽

Benign Thyroid

ABSTRACT Aims and objectives To analyze redo thyroidectomies so as to get a possible answer to the controversy surrounding thyroidectomy for benign disease. Materials and methods This is a retrospective observational cohort. From 1996 to 2010, a total 77 cases of redo thyroidectomies were performed. The data of all patients in the department were maintained on a self developed MS access-based software. The data of redo thyroidectomies were reviewed. These patients were from five districts of Andhra Pradesh, 42 were women and 35 men, 51 underwent subtotal thyroidectomy, 21 had hemithyroidectomy and 5 patients had excision procedure; all were benign. The condition varied from multinodular goiter (MNG) and solitary nodule to follicular neoplasm. There were 44 right-sided, and 43 left-sided surgeries. Recurrence occurred in seven in less than 1 year, in 49 in less than 5 years, in 11 of them in less than 10 years and 10 had recurrence after 10 years. A total thyroidectomy was performed in all. Seventy-five had benign disease. Two had suspected neoplasm; one papillary and one Hurthle cell. One patient had transient recurrent laryngeal nerve palsy. Results Seventy-seven redo surgeries for benign thyroid disease were performed. The high rate of referrals for recurrence probably suggests inadequacy of subtotal and hemithyroidectomies for benign thyroid diseases. Conclusion The present series of 77 redo thyroidectomies clearly suggests inadequacy of initial subtotal thyroidectomy. Evidence-based analysis of complication rates and surgical feasibility supports total thyroidectomy as the complete safe, scientifically acceptable choice of primary surgical treatment for benign thyroid disease. How to cite this article Prasad RG. Is it Time to Shift to Total Thyroidectomy for Benign Thyroid Disease: An Analysis of 77 Redo Thyroidectomies. Int J Phonosurg Laryngol 2015;5(1):4-6.

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Total Thyroidectomy for Benign Thyroid Diseases: What is the Price to be Paid?

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2016/18733.7991 ◽

2016 ◽

Cited By ~ 1

Author(s):

Rajashekara Babu Gangappa

Keyword(s):

Total Thyroidectomy ◽

Thyroid Diseases ◽

Benign Thyroid

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Evaluation of total thyroidectomy in benign thyroid diseases

Menoufia Medical Journal ◽

10.4103/1110-2098.132807 ◽

2014 ◽

Vol 27 (1) ◽

pp. 205

Author(s):

HanyIbrahim Sedhom ◽

HatemMahmoud Sultan ◽

HossamAbd El-Kader Ahmed

Keyword(s):

Total Thyroidectomy ◽

Thyroid Diseases ◽

Benign Thyroid

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Complications of Total Thyroidectomy in 50 Cases in The Department of Endocrine Surgery in BSMMU

Journal of Surgical Sciences ◽

10.3329/jss.v17i1.43700 ◽

2019 ◽

Vol 17 (1) ◽

pp. 25-29

Author(s):

Md Alamgir Hossain Sikder ◽

AEM Mahfuzur Rahman ◽

Abul Khair ◽

Md Jahangir Alam ◽

Mohammed Rafiqul Lslam

Keyword(s):

Total Thyroidectomy ◽

Multinodular Goiter ◽

Endocrine Surgery ◽

Published Data ◽

Female Ratio ◽

Male Female Ratio ◽

A Prospective Study ◽

Surgery Department

Objective: To determine the complications of the patients undergoing total thyroidectomy. Method: A prospective study was held at Department of Endocrine Surgery in BSMMU from January 2006 to December 2006 Method: Fifty patients with multinodular goiter and carcinoma thyroid of both sexes were selected from admitted patient of endocrine surgery department. All patients were evaluated preoperatively and total thyroidectomy was done and post operative was followed up. Out of 50 patients 35 patients were female and 15 patients male, male - female ratio 1 :2.3. 40 patients were carcinoma thyroid, 10 patients were multinodular goiter. The overall incidence of postoperative complication in this series was 4. out of 50 patients 1 patient developed haematoma. 1 patient developed wound infection and 1 patient developed transient tetany on 2nd postoperative day which was improved later on. 1 patient developed a thyroid nodule 6th month after total thyroidectomy for carcinoma thyroid. In long term from total thyroidectomy 40 patients were followed up, 10 patients did not attend an subsequent follow up. Out of 40 patients 36 patients were out of complication. Conclusion: The results are comparable with the current published data and demonstrate that total thyroidectomy can performed with minimum complication rate. Journal of Surgical Sciences (2013) Vol. 17 (1) : 25-29

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Hypoparathyroidism in Total Thyroidectomy due to Benign Thyroid Diseases

Clinical Therapeutics ◽

10.1016/j.clinthera.2018.04.004 ◽

2018 ◽

Vol 40 (5) ◽

pp. 762-767

Author(s):

Burak Ertaş ◽

Bayram Veyseller ◽

Abdullah Karataş ◽

Alper Özdilek ◽

Remzi Doğan ◽

...

Keyword(s):

Total Thyroidectomy ◽

Thyroid Diseases ◽

Benign Thyroid

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Solitary nodule thyroid: diagnosis and management

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20173033 ◽

2017 ◽

Vol 3 (3) ◽

pp. 611

Author(s):

M. Deepthi ◽

P. S. Sukthankar ◽

K. Narsimloo

Keyword(s):

Prospective Study ◽

Total Thyroidectomy ◽

Medical Therapy ◽

Multinodular Goiter ◽

Outpatient Department ◽

Multinodular Goitre ◽

Malignant Nodule ◽

Solitary Nodule ◽

Benign Nodules ◽

A Prospective Study

Background: Solitary nodule can be a true solitary nodule or a dominant nodule of multinodular goitre or ectopic thyroid or unilateral agenesis. Solitary nodule can be benign or malignant. Purpose of evaluation is to differentiate between the two. Methods: A prospective study of solitary nodule thyroid (STN) patients presenting to ENT outpatient department, for a period of 3 years from September 2012 to 2015. Results: Out of 67 patients enrolled into study, 53 patients had benign true STN, 9 patients had multinodular goiter (MNG) presenting as solitary nodule and 5 had malignant nodule (7.46%). Among the benign nodules, 25 patients had small solitary nodule (<4 cm size). They were treated medically and followed-up for a period of 1 year. 28 patients with large benign solitary nodules (>4 cm size) were taken up for surgery directly. Hemithyroidectomy was done in benign STN patients (39 patients) and total thyroidectomy was done in malignant nodule and MNG patients and followed-up by lifelong L-T4 therapy. Conclusions: Small benign solitary nodules regress with medical therapy alone. In large solitary nodules, and in those nodules not regressing with medical therapy, hemithyroidectomy is adequate. In MNG and malignant nodules, total thyroidectomy is advocated. Hemithyroidectomy and total thyroidectomy patients were followed - up with suppression and supplementation therapy respectively.This area being fluorotic belt, there is an increased prevalence of goiter. This study gives a concise guideline in evaluation and management of STN for goiter endemic areas.

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