Treatment Outcome of Total Thyroidectomy for Multinodular Goiter

Toluee, Mohammad; Hedayati-Emami, Mohammad Hassan; Barzegar-Savasari, Mohammad Reza; Shahrousvand, Yousef; Mobayen, Mohammadreza

doi:10.17795/zjrms1026

Cited by 3 publications

(3 citation statements)

References 23 publications

(24 reference statements)

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“…This value is compared well with studies from Yemen, Tanzania, KSA, and Sudan (mean age of 35.2, 40, 38.4, 43.7, and 43.9 respectively) [4,9,14,2,18]. whereas other studies showed higher figures (47.1, 48.4, 58.5) [31,34,36]. Most of the patients in this study came from rural areas located at a considerable distance from the hospital.…”

Section: Discussionsupporting

confidence: 86%

Surgical management of thyroid gland swellings in 22 May Hospital, Aden, Yemen

Bin-Gadeem

2021

Univ. Aden J. Nat. and Appl. Sc.

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Thyroid gland swellings are common clinical presentation of thyroid disorders of various etiologies, to which thyroidectomy is often carried out. The study aimed at analyzing demographic, clinical and pathologic features of patients with thyroid gland swellings, presented to 22 May Hospital and operated during the study period.as well as studying the types of operation used and their complications. This is a retrospective study. All patients who presented to 22 May Hospital from 1st March 2018 to 28th February 2020 and operated were included in the study. Patients with cervical lymphadenopathy, retrosternal goiter, and extrathyroidal tumor invasion were excluded from the study. Relevant data were collected and processed. For statistical analysis, SPSS software vs.17 was used. The Freeman and Halton extension of Fischer exact test was completed using Vassarstat. P-value of ≤0.05 was considered statistically significant. The study included 117 patients. Female preponderance was noted (91.5%). The average age group was 39.4 yrs, with SD ±13.8. Patients had an average duration of complain 50.3 months with SD ± 67.8. Most patients were euthyroid (88.1%) and had no previous thyroid operation (94%). The overall cancer detection rate on histopathology exam was 12% and papillary thyroid cancer was the most frequent histopathologiccancer type (92.8%). Statistically significant difference was found in the cancer detection rate in the different forms of thyroid swellings, the highest rate was found in solitary thyroid nodule (33.3%). Incidental thyroid cancer was found in 2.5% of the research population, but the histopathologic examination of their completed thyroidectomy specimen showed no cancer remnant. The total thyroidectomy was the most frequently practiced thyroidectomy procedure (45.8% of operations). No statistically significant difference was found in the major complications of thyroidectomy procedures of different resection extent. It could be concluded from this study that cancer detection rate in solitary thyroid nodule is significant, therefore, it needs to be carefully identified and investigated thoroughly.

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Section: Discussionsupporting

confidence: 86%

Surgical management of thyroid gland swellings in 22 May Hospital, Aden, Yemen

Bin-Gadeem

2021

Univ. Aden J. Nat. and Appl. Sc.

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“…As far as RLNI and hypocalcemia are concerned there are studies 8 which state that they are comparable in both groups. 9 M. Toluee 10 and Ali M. 11 and Ciriochi R. 12 in their articles support the view of preferring TT in place of STT, for treatment of multinodular goiter explaining that total thyroidectomy obviates the need for redo surgery with associated high rate of RLNI and also ensures removal of carcinoma if present. Ciriochi after Meta-analysis of 1430 records with 1305 patients, states that NTT is supposed to be equally effective but safer than TT.…”

Section: Resultsmentioning

confidence: 94%

Comparison of Near Total thyroidectomy with Sub total thyroidectomy for Multindular goipe in terms of recurrence rate.

Rashid

2021

TPMJ

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Objective: To compare the outcome of NTT and STT for multinodular goiter in terms of Recurrence rate. Study Design: Experimental study. Setting: Department of Surgery DHQ Teaching Hospital Rawalpindi. Period: July 2016 to December 2017. Material & Methods: All patients were admitted through OPD according to the already set inclusion and exclusion criteria. Two groups were made first group was NTT group and second group was STT group. Patients were divided into two groups by lottery method (Probability sampling). Follow up period for recurrence was 1 year. Analysis of data was done by SPSS version -20. Chisquare test was used to see the statistical significance. Value of P was set at 0.05. Results: A total of 63 (n=63) patients were included in the study. Over all there were 71.40% females and 28.60% males. Average age of the female patients was 36.3 years and in males average age was 40.60 years. In NTT group there were 32 patients (n=32) and in STT group there were 31 patients (n=31). There was no recurrence in NTT group whereas recurrence was noted in 5 out of 31 patients (16.10%) in STT group which was found statistically significant (p = 7.61). Overall incidental carcinoma was noted in 6 out of 63 patients (9.52%). So completion thyroidectomy had to be carried in 4 patients of incidental carcinoma from STT group whereas 2 patients of incidental carcinoma from NTT group did not require any further treatment. Conclusion: Results of this study prove the superiority of NTT over STT regarding recurrence rate and safety of treatment for multinodular goiter. NTT eliminates recurrence rate of MNG which is very high in STT. NTT also obviates the need for completion thyroidectomy in case of incidental carcinoma.

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“…We strongly believe and recommend TT for benign disease because of nonpossibility of recurrent disease, especially for diffuse MNG of the two lobes, GD and TA, with diffuse MNG of the rest tissue [15].…”

Section: Discussionmentioning

confidence: 96%

Evaluation of Total Thyroidectomy for Treatment of Benign Diseases of Thyroid Gland

Чоланчески

Tolevska

Qafjani

et al. 2020

Open Access Maced J Med Sci

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BACKGROUND: The controversy of using total thyroidectomy (TT) in treatment of benign thyroid diseases still remains controversial over the rates of complication, mostly recurrence nerve palsy and hypocalcemia, compared to non-total thyroidectomies. The latest reports in this field of research showed that that the number of complications of TT is decreasing as the skills of surgeons increase. AIM: In this study, we reviewed 209 cases of total thyroidectomies for benign thyroid diseases where such surgery was indicated. The results were evaluated whether they support the previous reports that TT is save method of treatment of diffuse multinodular goiters, Graves’ disease thyroid adenomas with diffuse goiters and thyroiditis. METHODS: Two hundred and nine patients, 36 males and 173 females, medium age 47 (17–77) operated with TT between 2016 and 2018 were included in the evaluation study. We evaluated the: Diagnosis, indications for operation, pre-operative medication administration, laryngeal recurrent nerve palsy, hypocalcemia, hypoparathyroidism, and patohistology findings. The follow-up for hypocalcemia and laryngeal nerve palsy was performed 1 year postoperatively. RESULTS: The age of the patients was between 17 and 77 years, medium-range 47 years old. Of 209 patients, 173 (83%) were female and 36 (17%) male with a gender ratio of 1:4.8 males to females. Diagnoses before surgery were established as follows: Multinodular euthyroid goiter (MNEG) n = 106 (48.80%), multinodular toxic goiter n = 12 (5.74%), Graves’s disease n = 6 (2.87%), adenoma with multinodular goiter n = 73 (34.92%), and n = 16 (7.65%) patients with thyroiditis. Recurrence laryngeal nerve palsy (RLNP) occurred in 6 patients (2.87%), temporary within 3 months after the operation in 4 patients (1.92%) and permanent palsy within 6 months and more after an operation in 2 patients (0.95%). Voice hoarseness immediately and within 1 month after the operation was registered in 32 patients (15.3%). RLNP and hoarseness were registered mostly in patients with pre-operative problems, mostly with extra big MNEG. One of the permanent injuries of RLN was bilateral and all others were one sided. All patients were operated with normal pre-operative vocal cord movement findings. Post-operative hypocalcemia was registered in 35 patients (16.74%). Temporary nonsignificant hypocalcemia in 10 (4.78%), temporary significant hypocalcemia in 17 (8.13%), temporary severe hypocalcemia in 6 patients (2.87%), and permanent hypocalcemia in 2 patients (0.95%). CONCLUSION: Many studies have shown that the rate of complications is almost even for TT and NTT done for benign and malignant diseases of thyroid gland. Our data have shown that the risk of post-operative complications with TT is proportional to the number of complicated pre-operative findings of benign thyroid glands.

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Treatment Outcome of Total Thyroidectomy for Multinodular Goiter

Cited by 3 publications

References 23 publications

Surgical management of thyroid gland swellings in 22 May Hospital, Aden, Yemen

Surgical management of thyroid gland swellings in 22 May Hospital, Aden, Yemen

Comparison of Near Total thyroidectomy with Sub total thyroidectomy for Multindular goipe in terms of recurrence rate.

Evaluation of Total Thyroidectomy for Treatment of Benign Diseases of Thyroid Gland

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