Comparison of Different Thyroidectomy Techniques for Benign Thyroid Disease

Extent of thyroidectomy in the management of benign thyroid disease remains controversial. In this clinical study, three different thyroidectomy techniques were compared by means of the complication, short period recurrence and L-thyroxin requirement rates. Two hundred consecutive patients who had b...

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Bibliographic Details
Published in:	ENDOCRINE JOURNAL Vol. 50; no. 6; pp. 723 - 727
Main Authors:	KOYUNCU, Ayhan, DÖKMETAS, Hatice Sebila, TURAN, Mustafa, AYDIN, Cengiz, KARADAYI, Kürsat, BUDAK, Elvan, GÖKGÖZ, Sehsuvar, SEN, Metin
Format:	Journal Article
Language:	English
Published:	Japan The Japan Endocrine Society 2003
Subjects:	Adolescent Adult Aged Benign thyroid disease Bilateral subtotal thyroidectomy Carcinoma, Papillary - diagnosis Carcinoma, Papillary - surgery Dunhill procedure Female Follow-Up Studies Humans Hypocalcemia - etiology Male Middle Aged Postoperative Period Recurrence Reoperation Surgical Wound Infection - etiology Thyroid Diseases - drug therapy Thyroid Diseases - surgery Thyroid Neoplasms - diagnosis Thyroid Neoplasms - surgery Thyroidectomy - adverse effects Thyroidectomy - methods Thyroxine - therapeutic use Total thyroidectomy Vocal Cord Paralysis - etiology
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Summary:	Extent of thyroidectomy in the management of benign thyroid disease remains controversial. In this clinical study, three different thyroidectomy techniques were compared by means of the complication, short period recurrence and L-thyroxin requirement rates. Two hundred consecutive patients who had bilateral subtotal thyroidectomy (BST) (n = 71), unilateral total lobectomy + contralateral subtotal lobectomy (Dunhill Procedure (DP)) (n = 71), or total thyroidectomy (TT) (n = 58) for benign thyroid disorders were included in this study. One patient was re-operated due to bleeding in BST group. Wound infection was observed in 1 patient both in BST and DP group and 2 patients in TT group. Temporary hypocalcaemia was seen in 14 (19.7%) of BST group, in 19 (26.7%) of DP group, and in 14 (24.1%) patients of TT group (p>0.05). Transient recurrent laryngeal nerve palsy developed in 1 patient both in DP and TT group. One patient of DP group had secondary thyroidectomy due to postoperative diagnosis of papillary carcinoma. There was no significant difference in the mean durations of hospitalization between the groups. Mean postoperative follow-up periods were 27.7 months (6-56), 34.8 months (8-55), 26.5 months (6-54) in BST, DP and TT groups, respectively. While all patients were administered L-thyroxin in TT group, 26 (36.6%) patients in DP group and 34 (47.8%) patients in BST group needed no L-thyroxin supplementation and L-thyroxin requirement rates were not different in either group. We think that total thyroidectomy should be adopted for benign thyroidal diseases, because its complications are no different than those for BST and DP. If individual factors and patient's preference are not in favor of lifelong L-thyroxin supplementation, however, DP may be carried out for benign thyroidal diseases instead of BST.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0918-8959 1348-4540
DOI:	10.1507/endocrj.50.723