Total versus sub-total thyroidectomy for multinodular goiter

ABSTRACT

The aim of the study was to compare total and subtotal thyroidectomy [STT] for benign bilateral multinodular goiter [BBMNG] in terms of the proportion of hypoparathy-roidism and recurrent laryngeal nerve paralysis [RLNP]. Quasi experimental Place and duration of study Department of Surgery, Khyber Teaching Hospital Peshawar, from 1st October 2007 to 30th September 2008. A total of 60 patients with bilateral multinodular goiter, were divided in to two groups A and B [30 patients in each group]. Group A patients were subjected to IT while group patients to STT. Sample technique used was non-probability purposive. Demographic details, biochemical findings, indications for operation, operating time and complications under study were noted for either group. There was no significant difference in the age, gender, hormonal status or duration of goiter between the two groups [P=0.123, P=0.74, P=0.509 and P=0.6, respectively]. The mean operating time was longer [138 +/- 30 min versus 112 +/- 33 min, P=0.046] for TT vs STT. Either temporary RLNP or HPT occurred in 3 [9.9%] or 6 [20%] of the patients undergoing total compared with 2 [6.6%] or 3 [9.9%] of the patients undergoing SIT [P=0.64 and P=0.278, respectively]. Permanent RLNP was observed in none and HPT in one patient only in TT group compared with none of either complication in STT group [P=0.313 for permanent HPT]. The present study shows that TT can be performed without increasing risk of complications, and it is an acceptable alternative for benign MNG, especially in endemic regions, where patients present with a huge multinodular goiter