Malignancy and Complication Rate in Reoperation of Recurrent Goiter

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Objective: The aim of this study was to evaluate the fine needle aspiration biopsy findings of recurrent goiter patients who were operated subtotally or lobectomised for benign causes, and to determine the malignancy and complication rates for those who were reoperated. Methods: Between 2008 and 2009, 114 patients diagnosed with recurrent goiter were involved in this study. The cytological findings of 158 nodules and histological findings of 18 patients with reoperation were examined. The complications of primary surgery and reoperation of recurrent goiter were determined. Results: The operation indications were euthyroid multinodular goiter in 106 of the patients and toxic multinodular goiter in 8 of them. The average time elapsed from the time of the first operation was 16.5±7.5 years. The patients with a fine needle aspiration biopsy resulted in 6 with suspicion of malignancy, 3 with malignancy, 5 with hurtle cell cytology, 7 with cellular microfollicular lesion, 1 patient with toxic multinodular goiter and 2 with inadequate cellular cytology; a total of 24 patients (21%) were asked for reoperation. Among the 18 patients who accepted reoperation, pathology results discovered 2 papillary microcarcinomas and 2 papillary thyroid carcinomas. A total of 7 of the 18 patients with reoperation had surgical complications: 3 had vocal cord paralysis and 4 had hypoparathyroidism. Conclusion: In our study, we found that a high rate of recurrent goiter patients required reoperation and there was a considerable amount of complication rate of reoperative thyroid surgery. To eliminate the potential risk of reoperation, we recommend a total thyroidectomy instead of subtotal thyroidectomy or lobectomy as the surgery of choice for the primary surgery with benign indications.