RESUMO
Surgery for simple multi-nodular goiter affecting both thyroid lobes usually necessitate near total thyroidectomy to avoid recurrence, but this leads to inevitable postoperative hypothyrosdism requiring thyroxine replacement therapy which not only life long but also not without morbidity. The aim of this study is to evaluate the ability of fresh thyroid auto-transplant after thyroidectomy for muiti-nodular goiter to survive, grow and restore normal thyroid function as an alternative to life long thyroxine replacement. This study includes 25 patients complaining of bilateral simple multi-nodular goiter whom undergo near total thyroidectomy [NTT] with intra-sternomastoid muscle auto-transplantation of about 1 cm of fresh thyroid tissue which was proved normal clinically and by intra-operative frozen section with further post-operative paraffin section examination of all specimens. All patients were followed post-operatively by thyroid function tests and [99]mTc-pertchnetate thyroid scanning. The transplanted fresh thyroid tissue was surviving and growing in all patients but with variable functions. Euthyroid state was obtained in 23 patients within the first 6 months with 2 patients remain in hypothyroid state requiring thyroxine replacement therapy in variable doses. With further follow-up for another 6 months, one patient from euthyroid group developed hypothyroidism necessitated starting thyroxine replacement therapy. The auto-transplanted fresh thyroid tissue is able to survive and grow with the ability to restore normal thyroid function with variable degree making this technique a magic alternative to life long thyroxine therapy in most cases