Postoperative hypothyroidism after thyroidectomy for nontoxic multinodular goiter: Can we prevent it by leaving more?

Abstract

Introduction: A study was done to evaluate the function of the thyroid remnant after subtotal and near total thyroidectomy (STT and NTT) in nontoxic multinodular goiter (MNG) by using radioactive iodine uptake (RAIU) and serum thyroid stimulating hormone (TSH), after leaving variable amounts of remnant thyroid tissue. Materials and Methods: A prospective study included 25 patients with nontoxic MNG over a period of 18 months where in STT and NTT was performed. Depending on the availability of the normal thyroid tissue found intraoperatively, a definite volume of thyroid tissue was left in the tracheoesophageal groove along the recurrent laryngeal nerve. Serum TSH and RAIU were performed 4 weeks after surgery. Patients were divided into three groups A, B, and C depending on the size of thyroid remnant left during surgery that is a volume of 5 mL, respectively. Results: There is no statistical significant correlation seen between the size of the remnant thyroid tissue, hypothyroidism, and the postoperative serum TSH value. RAIU study conducted at 4 weeks postsurgery showed no correlation between the volume of the thyroid tissue remnant and its RAIU uptake. Conclusion: The thyroid function of the patients after thyroidectomy does not depend on the volume of the thyroid remnant left. There may be many other factors which determine the thyroid function like the total preoperative gland mass, histopathological nature of the gland, sex, and preoperative thyroid function.