Total Thyroidectomy versus Near Total thyroidectomy in Surgical Management of Patients of Multinodular Goiter


Background: Near total thyroidectomy represented an appealing option for junior surgeons to perform in managing multinodular goiter however total resections in the hands of well-trained surgeons are safe and resect the whole gland with no need for completion surgery in cases of occult malignancy.Objectives: to compare the results of neat total with total thyroidectomy.Patients and Methods: 100 cases of total thyroidectomy are compared with 100 cases of near total thyroidectomy, prospectively and in continuously updated bases ,those patients admitted to Al Hilla General Teaching Hospital from Dec 2008 to Sep 2013.Average age in total thyroidectomy cases was 41 and in near total thyroidectomy cases was 38 and male: female ratio was 1:2.2 and 1:2.7 respectively.Results: No permanent complications were faced in both groups apart from hypothyroidism in all cases.Conclusion: No advantages for near total thyroidectomy. Occult malignancy detected on postoperative histopathology of near total resections may need completion surgery which carries the highest incidence of complication. Near total thyroidectomy is no more recommended for surgeons with sufficient training to perform total resections.