Total Thyroidectomy: The Procedure of Choice for Multinodular Goitre
Abstract
OBJECTIVE: To review our experience of total thyroidectomy for bilateral multinodular goitre. DESIGN: Prospective open study. SETTING: Teaching hospital, Malaysia. SUBJECTS: 98 consecutive patients whose bilateral multinodular goitres were treated by total thyroidectomy, January 1998-November 1999. INTERVENTION: A revised technique of total thyroidectomy in which more attention than is customary was paid to the exposure and safety of the laryngeal nerves and the parathyroid glands. All patients had at least 1 parathyroid gland autotransplanted. MAIN OUTCOME MEASURES: Morbidity and mortality RESULTS: There were no injuries to the recurrent laryngeal nerves and no patient developed persistent hypocalcaemia; 27/98 developed transient hypocalcaemia, but this had settled by 6 months postoperatively. 59 patients had persistent symptoms of pressure preoperatively, and these all resolved by 3 months postoperatively. 6 patients had occult malignant disease discovered on histological examination, and 3 developed minor wound infections. CONCLUSIONS: Total thyroidectomy is the procedure of choice for bilateral multinodular goitres, provided that sufficient attention is paid to the preservation of the laryngeal nerves and the parathyroid glands.
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Near-total or total thyroidectomy can be performed with the same low rate of complications as subtotal thyroidectomy.
“This procedure can be performed with the same low rate of complications as a subtotal thyroidectomy (286-289).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [289]
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- Authors
- N. Hisham, A. F. A.
- Venue
- The European Journal of Surgery
- Publisher
- Oxford University Press (OUP)
- Published
- 2001-06-01
- Volume
- 167
- Issue
- 6
- Pages
- 403-405
- ISSN
- 1102-4151 (ISSN-L)
- OpenAlex
- W2163590296
- Cited by
- 47
- References
- 11
- Citations by year
- 2025: 1 · 2023: 2 · 2020: 2 · 2018: 1 · 2016: 1 · 2015: 1 · 2014: 3 · 2013: 2 · 2012: 4
- FWCI
- 3.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The European Journal of Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Head and Neck Anomalies
- Keywords
- total thyroidectomy, multinodular goiter, recurrent laryngeal nerve preservation, parathyroid autotransplantation, postoperative hypocalcemia, surgical morbidity, wound infection
- MeSH terms
- Adolescent, Adult, Aged, Female, Goiter, Nodular, Humans, Male, Middle Aged, Parathyroid Glands, Prospective Studies, Thyroidectomy, Transplantation, Autologous
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