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

Background The purpose of the present work was to compare rates of postsurgical complications following thyroidectomy for multinodular goiter through a retrospective multicenter cohort study. Methods All cases of thyroidectomy (total—TT; near total—NT; and bilateral subtotal—ST) performed in two hos...

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Bibliographic Details
Published in:World journal of surgery 2008-07, Vol.32 (7), p.1546-1551
Main Authors: Vaiman, Michael, Nagibin, Andrey, Hagag, Philippe, Buyankin, Alexey, Olevson, Julian, Shlamkovich, Nathan
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adult
Cardiac Surgery
Female
General Surgery
Goiter, Nodular - surgery
Humans
Hypoparathyroidism
Male
Medicine
Medicine & Public Health
Middle Aged
Multinodular Goiter
Postoperative Complications - epidemiology
Recurrent Laryngeal Nerve
Recurrent Laryngeal Nerve Injury
Retrospective Studies
Surgery
Thoracic Surgery
Thyroidectomy - adverse effects
Thyroidectomy - methods
Total Thyroidectomy
Vascular Surgery
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Summary:Background The purpose of the present work was to compare rates of postsurgical complications following thyroidectomy for multinodular goiter through a retrospective multicenter cohort study. Methods All cases of thyroidectomy (total—TT; near total—NT; and bilateral subtotal—ST) performed in two hospitals from 1990 to 2005 were studied to determine the incidence of complications after each procedure. Follow-up checked injury of laryngeal nerves, hypoparathyroidism, hypothyroidism, pathology recurrence, and appearance of neoplasm. Results There were 6,223 cases: TT, n  = 3,834 (61.6%); ST, n  = 2,238 (36%); and NT, n  = 151 (2.4%) NT). Of this total, 2,758 (44.3%) patients were men and 3,465 (55.7%) were women with a mean age of 48.7. Postoperative mean follow-up was 7 years, 2 months. Permanent recurrent laryngeal nerve (RLN) injury was observed in 1.4% in the TT group, 1.2% in the ST group, and 1.1% in the NT group ( p  > 0.1). Permanent hypocalcemia was observed in 2% in TT group, 1.9% in the ST group, and 2% in the NT group ( p  > 0.1). Permanent hypothyroidism occurred in all patients in the TT and NT groups, compared to 91% of the patients in the ST group ( p  > 0.1). Recurrence of benign disease was noted in 491 patients (20.5% of ST and NT cases combined; p  
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-008-9541-9