PURPOSE: The indications for surgical treatment of multinodular goiter (MNG) are pressure symptoms, suspicion of malignancy, and cosmetic concerns. We report our clinical experience of performing total thyroidectomy (TT) for MNG, focusing on outcome and complications, to evaluate its effectiveness. METHODS: The medical records of 154 patients who underwent TT for MNG between 2005 and 2007 were reviewed retrospectively. We examined the ratio of thyroid nodules to the thyroid gland, pathological fine-needle aspiration biopsy findings, and the ultrasonographic characteristics of the nodules, and recorded the early and late postoperative complications. RESULTS: The most frequent indications for surgery were large nodules with or without radiological suspicion of malignancy (65%), hyperthyroidism (20%), and cosmetic problems or compression symptoms (15%). Seventeen (11%) patients had symptomatic, transient hypocalcemia, and 1 (0.6%) had permanent hypocalcemia. Other complications included hematoma in 1 (0.6%) patient, temporary unilateral recurrent laryngeal nerve palsy in 10 (6.4%), permanent unilateral recurrent laryngeal nerve palsy in 3 (1.9%), and seroma in 2 (1.3%). There was no significant relationship between complications and histopathology, nodule size, thyroid size, hyperthyroidism, age, or gender. CONCLUSION: Total thyroidectomy is the right surgical decision for MNG since it achieves complete remission of symptoms and eliminates malignancy, with low morbidity and mortality rates.
PURPOSE: The indications for surgical treatment of multinodular goiter (MNG) are pressure symptoms, suspicion of malignancy, and cosmetic concerns. We report our clinical experience of performing total thyroidectomy (TT) for MNG, focusing on outcome and complications, to evaluate its effectiveness. METHODS: The medical records of 154 patients who underwent TT for MNG between 2005 and 2007 were reviewed retrospectively. We examined the ratio of thyroid nodules to the thyroid gland, pathological fine-needle aspiration biopsy findings, and the ultrasonographic characteristics of the nodules, and recorded the early and late postoperative complications. RESULTS: The most frequent indications for surgery were large nodules with or without radiological suspicion of malignancy (65%), hyperthyroidism (20%), and cosmetic problems or compression symptoms (15%). Seventeen (11%) patients had symptomatic, transient hypocalcemia, and 1 (0.6%) had permanent hypocalcemia. Other complications included hematoma in 1 (0.6%) patient, temporary unilateral recurrent laryngeal nerve palsy in 10 (6.4%), permanent unilateral recurrent laryngeal nerve palsy in 3 (1.9%), and seroma in 2 (1.3%). There was no significant relationship between complications and histopathology, nodule size, thyroid size, hyperthyroidism, age, or gender. CONCLUSION: Total thyroidectomy is the right surgical decision for MNG since it achieves complete remission of symptoms and eliminates malignancy, with low morbidity and mortality rates.
Authors: Serdar Ozbas; Savas Kocak; Semih Aydintug; Atil Cakmak; Mehmet Ali Demirkiran; Gordon C Wishart Journal: Endocr J Date: 2005-04 Impact factor: 2.349
Authors: Erik K Alexander; Shelley Hurwitz; Jenny P Heering; Carol B Benson; Mary C Frates; Peter M Doubilet; Edmund S Cibas; P Reed Larsen; Ellen Marqusee Journal: Ann Intern Med Date: 2003-02-18 Impact factor: 25.391
Authors: Lodovico Rosato; Nicola Avenia; Paolo Bernante; Maurizio De Palma; Giuseppe Gulino; Pier Giorgio Nasi; Maria Rosa Pelizzo; Luciano Pezzullo Journal: World J Surg Date: 2004-02-17 Impact factor: 3.352
Authors: Anita Kurmann; Forian Martens; Roman Inglin; Stefan W Schmid; Daniel Candinas; Christian A Seiler Journal: Langenbecks Arch Surg Date: 2012-07-18 Impact factor: 3.445