TOTAL THYROIDECTOMY FOR MULTI

Abstract

Objective: To assess the efficacy and safety of total thyroidectomy for benign multi-nodular goitre.
Study design: Descriptive study
Place and Duration of Study: The study was conducted in the Department of General Surgery, Combined Military Hospital Kharian from January 2004 to December 2008.
Materials and Methods: A total of 66 patients with bilateral benign multi-nodular goitre (61 females & 5 males) underwent total thyroidectomy. Sixty two cases were euthyroid while 4 had hyperthyroidism. Surgical dissection techniques involved identifying both recurrent laryngeal nerves through out their course, securing of parathyroid glands with their intact blood supply and ligation of inferior thyroid artery branches close to the thyroid capsule. All the patients were evaluated post operatively for signs of recurrent laryngeal nerve injury and hypoparathyroidism and other complications. All patients were put on thyroxin replacement therapy post-operatively and were followed for 9 to 12 months.
Results: There was no injury to the recurrent laryngeal nerves. One case of injury to external laryngeal nerve was found. Transient hypocalcaemia occurred in 4 patients without permanent hypoparathyroidism. All cases of transient hypocalcaemia recovered fully within 3 months. Four patients had occult malignancy diagnosed post-operatively on histo-pathology.
Conclusions: In experienced hands, total thyroidectomy is an effective and relatively safe operation for benign multi-nodular goitre and its complication rate is same as that of a sub-total thyroidectomy.