Efficacy of Total Thyroidectomy for Treatment of Benign Thyroid Lesions

Abstract

Background: Total thyroidectomy is currently the preferred treatment for thyroid cancer, multinodular goitre (MNG) and Graves' disease. However, many surgeons choose not to perform total thyroidectomy to treat benign thyroid diseases owing to the associated risk of postoperative hypoparathyroidism, recurrent laryngeal nerve damage and bleeding. We reviewed 100 total thyroidectomies performed for benign thyroid diseases, when surgery was indicated. Objective: Assessment whether total thyroidectomy is safe and can be considered as the optimal surgical approach for treating benign thyroid diseases. Patients and methods: This study was conducted on 100 patients presented by thyroid swellings and admitted to Mansoura University Hospitals, Endocrine Surgery Unit over one year during the period between November, 2017 and October, 2018. All patients were submitted to careful history taking, clinical examination and radiological and laboratory investigations. Total thyroidectomy was done to all patients. Patients were evaluated early postoperative at 1, 6 and 12 months by sr. TSH, total & ionized calcium, PTH and vocal cord assessment. Results: Preoperative diagnoses in our patients revealed that there were 74 cases MNG (74%), 2ry toxic 19 cases (19%) and 1ry toxic 7cases (7%). The incidence of permanent bilateral recurrent laryngeal nerve palsy was 0% and that of permanent unilateral recurrent laryngeal nerve palsy was 1%. Whereas the incidence of temporary unilateral recurrent laryngeal nerve palsy was 5%. Permanent hypocalcaemia occurred in 2% and overall temporary hypocalcaemia occurred in 8% of patients. Hemorrhage requiring repeat surgery occurred in 1% of patients. Conclusion: In our study, total thyroidectomy showed no significant operative and/or postoperative complications. Also, it was noticed that total thyroidectomy operation gave very good results in patients with benign thyroid diseases provided that they were done in qualified center and by experienced endocrine surgeons.