Total Thyroidectomy Versus Subtotal ThyroidectomyIn Multinodular Goitre– Our Experience

Abstract

Introduction Total thyroidectomy for the management of benign Multinodular goiter is controversial and since the development of other subspecialties, it adds to further confusion. The present study aims to retrospectively compare the efficacy and morbidity of total thyroidectomy and subtotal thyroidectomy. Methods A total of 170 patients with multi nodular goiter were assigned to have either total thyroidectomy (n=100) or subtotal thyroidectomy (n=70) based on preoperative evaluation, FNAC and indications for surgery. Complications and hospital stay were also noted. Results There was no significant difference in the rate of major complications between the two procedures. There was no significant difference in distribution of post operative compl9ocations among the groups. Temporary hypoparathyroidism resulted in 37 (22%) patients in total out of which 28 (28%) belonged to total thyroidectomy group and 9 (13%) belonged to the subtotal thyroidectomy group respectively which was statistically insignificant. No permanent or temporary recurrent laryngeal nerve palsy was noted. Hematoma 2 (3%) and stitch granuloma 3 (4%) was recorded in Subtotal group. Incidental papillary carcinoma was noted in 10 (6%) patients with total thyroidectomy. Recurrence was noted in 20 (298%) of patients and 7 were taken up for further surgery and the rest managed with L-Thyroxine. 80% of the total thyroidectomies were devoid of any complications as compared to only 54.28% of subtotal Thyroidectomies without complications. Conclusion Subtotal thyroidectomy provides an unpredictable outcome and the risk of permanent complications is not less than or at par with total thyroidectomy, so there appears little or none logical reason to recommend subtotal thyroidectomy. In our experience total thyroidectomy is radical but a definitive treatment method without the risk of recurrence with a small incidence of major complications as that of a less radical procedure.