Subtotal Versus Total Thyroidectomy for Benign Thyroid Disease - a Prospective Case-control Surgical Outcome Study.
The extent of thyroid resection in bilateral multinodular non-toxic goiter remains
controversial. Surgeons still continue to debate whether the potential benefits of total
thyroidectomy outweigh the potential complications. Most low-volume surgeons avoid to
perform total thyroidectomy owing to the possible complications such as permanent recurrent
laryngeal nerve palsy and permanent hypoparathyroidism. On the other hand, the increasing
number of total thyroidectomies are currently performed in high-volume endocrine surgery
units, and the indication for this procedure include thyroid cancer, Graves disease and
multinodular goiter. Recently there has been increasing acceptance for performing total
thyroidectomy for bilateral multinodular non-toxic goiter as it removes the disease process
completely, lowers local recurrence rate and avoids the substantial risk of reoperative
surgery, and involves only a minimal risk of morbidity. This common perception is based
largely on single-institution retrospective data, a few multi-institutional retrospective
experiences, and only a few small prospective studies comparing the outcomes of total vs.
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Crossover Assignment, Masking: Open Label, Primary Purpose: Treatment
Primary outcome measure was the prevalence of recurrent goiter, incidental thyroid cancer and need for revision thyroid surgery.
folow-up at yearly intervals following thyroidectomy
Marcin Barczynski, MD, PhD
Jagiellonian University, Medical College
Poland: Ministry of Health