Total Thyroidectomy Versus Subtotal ThyroidectomyIn Multinodular Goitre– Our Experience

Background: Multinodular goitre is one of the most common endocrine surgical problems. Because controversy still continues to surround the use of total thyroidectomy for management of simple nodular goitre, the present study was conducted to compare the complications between total and subtotal thyroidectomy for management of simple multinodular goitre.Materials & methods: The experimental study was conducted in the department of Surgery and ENT, Rajshahi Medical College Hospital over a period of 2 years from July 2011 to June 2013. Of the total 83 simple multinodular goitre patients – 38 were assigned to total and 45 to subtotal thyroidectomy groups. Student’s t-test was done to analyze the means of quantitative variables & Chi-square (X2) and Fisher Exact test was applied to analyze categorical variables.Results: Most (88.9%) of patients in subtotal thyroidectomy (STT) group and 86.8% in total thyroidectomy (TT) group did not receive any blood transfusion during operation. Only 1(2.2%) patient in STT group experienced significant intraoperative haemorrhage. All patients were successfully operated. However, few patients of either group experienced some complications. Tetany was developed in 7.89% patients of TT and 4.44% patients of STT group. The other complication was recurrent laryngeal nerve (RLN) palsy (5.3% in TT and 2.2% in STT groups). No case of postoperative haemorrhage (haematoma) or wound infection was occured in either group. In TT group 5 (13.16%) patients and in STT group 4 (8.89%) patients developed different complications with no significant difference between the groups (p=0.533). The mean postoperative hospital stay was higher in TT group than In STT group (6.21 ± 0.99 vs. 5.96 ± 0.79 days), though the difference is not statistically significant (p= 0.206).Conclusions: The study shows that total thyroidectomy can be performed without increasing risk of complications and is a better alternative to subtotal thyroidectomy for the treatment of simple multinodular goitre.J Shaheed Suhrawardy Med Coll, December 2017, Vol.9(2); 55-59

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Impact of pre-operative serum 25-hydroxyvitamin D on post-operative serum calcium in patients undergoing total thyroidectomy for benign goitre: retrospective study of 246 patients

The Journal of Laryngology & Otology ◽

10.1017/s0022215117001797 ◽

2017 ◽

Vol 131 (10) ◽

pp. 925-929 ◽

Cited By ~ 2

Author(s):

M Erlem ◽

N Klopp-Dutote ◽

A Biet-Hornstein ◽

V Strunski ◽

C Page

Keyword(s):

Parathyroid Hormone ◽

Retrospective Study ◽

Total Thyroidectomy ◽

Serum Calcium ◽

Univariate Analysis ◽

Multinodular Goitre ◽

Serum Parathyroid Hormone ◽

Single Centre ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D

AbstractObjective:To determine whether pre-operative serum 25-hydroxyvitamin D has an impact on post-operative parathyroid hormone and serum calcium levels in patients undergoing total thyroidectomy for benign goitre.Methods:This single-centre, retrospective study comprised 246 unselected surgical patients who had undergone total thyroidectomy for bilateral, benign, multinodular goitre. The correlation between pre-operative serum 25-hydroxyvitamin D and post-operative serum parathyroid hormone and serum calcium was studied to determine whether low pre-operative serum 25-hydroxyvitamin D was predictive of post-operative hypocalcaemia.Results:Seventy-nine patients (32 per cent) had post-operative hypocalcaemia. Eighteen patients (7.32 per cent) experienced unintentional parathyroidectomy (1 parathyroid gland in 15 patients, 2 parathyroid glands in 3 patients). In univariate analysis, pre-operative serum 25-hydroxyvitamin D was not correlated with post-operative serum calcium (p = 0.69) or post-operative serum parathyroid hormone (p = 0.5804). Furthermore, in multivariate analysis, which took into account unintentional parathyroidectomy, no correlation was found (p = 0.33). Bilateral unintentional parathyroidectomy was statistically associated with post-operative hypocalcaemia (p = 0.032).Conclusion:Pre-operative serum 25-hydroxyvitamin D did not appear to have any impact on post-operative serum calcium in patients undergoing total thyroidectomy for benign goitre.

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Total Thyroidectomy for Management of Benign Multinodular Goitre in an Endemic Region: Review of 620 Cases

Acta Chirurgica Belgica ◽

10.1080/00015458.2015.11681096 ◽

2015 ◽

Vol 115 (3) ◽

pp. 198-201 ◽

Cited By ~ 1

Author(s):

E. Alhan ◽

A. Usta ◽

S. Turkyilmaz

Keyword(s):

Total Thyroidectomy ◽

Multinodular Goitre ◽

Endemic Region

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Total Thyroidectomy: The Procedure of Choice for Multinodular Goitre

The European Journal of Surgery ◽

10.1080/110241502320127838 ◽

2002 ◽

Vol 168 (3) ◽

pp. 196-196 ◽

Cited By ~ 2

Author(s):

M. Kaushal ◽

G. Agarwal ◽

S. K. Mishra

Keyword(s):

Total Thyroidectomy ◽

Multinodular Goitre

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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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High rates of false negative cytological diagnosis and incidental multifocal microcarcinoma in solitary thyroid nodule and multinodular goitre, justifying a preference for total thyroidectomy

10.22541/au.159110391.18934205 ◽

2020 ◽

Author(s):

Ethem Unal ◽

Sema Yuksekdag

Keyword(s):

Thyroid Nodule ◽

Total Thyroidectomy ◽

False Negative ◽

Cytological Diagnosis ◽

Multinodular Goitre ◽

Solitary Thyroid Nodule

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Evaluation of Hypoparathyroidism following Total Thyroidectomy

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v26i2.50612 ◽

2020 ◽

Vol 26 (2) ◽

pp. 116-120

Author(s):

Md Nazmul Haque ◽

Saif Rahman Khan ◽

Moshammat Fatima Akhter ◽

Mohammad Ashequr Rahman Bhuiyan ◽

Mohammad Zakaria Sarker ◽

...

Keyword(s):

Total Thyroidectomy ◽

Neck Dissection ◽

Serum Calcium ◽

Calcium Supplementation ◽

Follicular Carcinoma ◽

Sampling Technique ◽

Multinodular Goitre ◽

Period 2 ◽

Parathyroid Function ◽

Malignant Lesions

The most common cause of hypoparathyroidism is damage to the glands during thyroid surgery. Parathyroid gland preservation during thyroidectomy is not only desirable, but essential for the effective management of surgical diseases of the thyroid gland Objective: To find out the incidence rate of hypoparathyroidism after total thyroidectomy. Methods: Study Period: 2 years from Jan 2017 to December 2018 Place of Study : National Institute of ENT, Tejgaon, Dhaka Study Design: Prospective Observational Study Sample size: 107 Sampling Technique: Convenient Sampling technique Results: Among the 107 cases 39 cases were malignant comprising 36.45% of the cases. toxic multinodular goitre were 6 cases among 107 cases (5.6%) and rest 62 cases were benign multinodular goitre with or without cystic change and follicular adenomas (57.94 %). 29 cases out of 39 malignant cases were papillary carcinoma of thyroid (74.36% of malignant lesions), 2 cases of medullary Ca thyroid (5.12 % of malignant lesions) rest 8 were follicular carcinoma (20.51% of malignant lesions). 26 out of 107 (24.30%) cases suffered from postoperative hypocalcaemic tetany within 1st-5th POD. Their parathyroid hormones were significantly reduced and serum calcium were also reduced and they required calcium supplementation. In 5 (4.67%) cases there was no sign and symptoms of tetany but their serum parathormone levels were little below normal level but serum calcium levels were normal and therefore no calcium supplementation were given. The rest 76 (71.03%) cases did not show any sign or symptoms of tetany and did not require calcium supplementation. Among the patients who suffered from tetany majority were cases of Carcinoma of thyroid (18 out of 26 patients of hypoparathyroidism) 69.23%, however lateral neck dissection did not seem to affect decline in parathyroid function as 10 out of 18 patients with thyroid malignancy who suffered from postoperative tetany undergone level II to level V neck dissection in addition to total thyroidectomy. Bangladesh J Otorhinolaryngol; October 2020; 26(2): 116-120

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