Total thyroidectomy for the surgical treatment of multinodular goiter

Abstract

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.

The neoplastic goitre

“…Similarly low rates (<2%) of long-term complication were reported by Dogan et al [7] in a series of 154 patients who underwent total thyroidectomy for MNG. Vasica et al [25] from the University of Sydney report on over 12 000 patients managed over a 20-year period spanning a change towards a policy of total thyroidectomy for benign MNG.…”

“…It is imperative, however, to ensure that for those cases in which there may be a need to perform a midline sternotomy, the operative field is prepared before surgery. Dissection and mobilization of the superior pole as a first step will allow cranial traction of the goitre and facilitate its dissection from the thoracic inlet and superior mediastinum [7,26].…”

Letter to “the Prevalence of Incidental Thyroid Carcinoma in Patients Who Underwent Thyroidectomy for Multinodular Goiter”

“…Secondly, in Turkey, including Ankara Numune Training and Research Hospital, total thyroidectomy is the preferred surgical procedure in multinodular goiter patients [2,3], but bilateral thyroidectomy rate was 32% in the presented article [1]. How do the authors explain this high bilateral subtotal thyroidectomy rate?…”

Impact of surgical technique on operative morbidity and its socioeconomic benefit in thyroid surgery

“…Operative and in-hospital costs for thyroidectomy were assessed on the basis of the Swiss All Patient DiagnosisRelated Groups (APDRG) 2010 (total costs, 8,190.20 EUR). The median salary of an inhabitant per month in Switzerland in 2008 was 4,512.93 EUR referred to the federal office for statistics in Switzerland.…”

“…In spite of sufficient dietary iodine intake in the present day, multinodular goiter remains an endemic disease in Switzerland [3]. Further research and understanding of the molecular growth mechanism in goitrogenesis [4][5][6] and an inacceptable high recurrence rate associated with subtotal thyroidectomy led endocrine surgeons to adopt a more extended surgical resection for benign multinodular goiter disease [7][8][9][10][11]. Previous studies showed that total thyroid resection is a safe procedure.…”