The Long‐term Outcome of Thyroidectomy for Sporadic Non‐toxic Goitre

Abstract

To study the long-term outcome after thyroidectomy, 113 sporadic non-toxic goitre patients who underwent thyroidectomy in our hospital in the period 1974-1983, were studied. Five patients complained of recurrent goitre; a goitre was found on inspection and palpation in these five and in 15 others. There were no differences between the 20 patients with goitre and the 93 patients without goitre with regard to sex, age, duration of goitre, indication and type of thyroidectomy, postoperative thyroid hormone medication, period of follow-up, and T4, T3, or TSH plasma values at the time of follow-up examination. Twenty-three patients complained of voice changes since thyroidectomy. In a case control study, included in this follow-up study, 19 patients with goitre, i.e. thyroid size I and II as estimated by inspection and palpation (cases), and 16 patients without goitre, i.e. thyroid size OA and OB (controls), were studied in more detail. No difference between cases and controls was found in any of the above mentioned parameters that could explain the recurrence of goitre. Thyroid volume (median) was greater in the cases (34.1 ml, range 7.9-83.4) than in the controls (10.3 ml, range 2.5-48.7) (P less than 0.001), although a considerable overlap between the two groups was observed. One or more thyroid nodules were found in 89.5% of the cases and in 62.5% of the controls (NS). Serum thyroid growth stimulating immunoglobulin (TGI) was present both in cases (68%) and controls (50%). TGI was present in high titres in all five patients who complained about recurrent goitre.(ABSTRACT TRUNCATED AT 250 WORDS)

Determinants of longterm outcome of radioiodine therapy of sporadic non‐toxic goitre

“…Thyroidectomy is very effective, albeit at the expense of a low but unavoidable morbidity (notably voice disabilities). Postoperative recurrences, however, do occur in 4–19% ( Berghout et al ., 1989 ), and apparently are not prevented by postoperative treatment with thyroxine ( Geerdsen & Froland, 1986; Hegedus et al ., 1987 ; Bistrup et al ., 1994 ; Berglund et al ., 1998 ). Thyroxine given in TSH‐suppressive doses is moderately effective.…”

Nodular recurrence and hypothyroidism following partial thyroidectomy for benign nodular thyroid disease in children and adolescents

“…Altogether, this could lead to an underestimation of recurrence in cases of small nonpalpable nodules. In addition, the definition of recurrence differs between authors, some only considering the increase in volume of the remaining thyroid tissue [16,17], others as us based on the presence of nodules [18,19]. Finally, the follow-up periods vary from one study to another, ranging from 12 months [16] to 10 years [17].…”

Reoperative Surgery for Benign Thyroid Diseases

“…These could perhaps represent a standard indication for total thyroidectomy in patients with multino-dular bilateral disease. Instead of the "dogma of total thyroidectomy", Berghout (20) noted otherwise that two accepted risk factors for recurrence as family history and bilateral disease were not statistically significant. The mean cause of recurrence is inadequate initial surgery and that is why reliable preoperative staging is essential.…”