Thyroxine Prophylaxis after Bilateral Subtotal Thyroidectomy for Multinodular Goiter

• Published in: ENDOCRINE JOURNAL Vol. 47; no. 3; pp. 349 - 352
• Main Authors: KULAÇOGLU, HAKAN, DENER, CENAP, ZIRAMAN, IPEK, KAMA, NURI A.
• Format: Journal Article
• Language: English
• Published: Japan The Japan Endocrine Society 2000
• Subjects: Adolescent; Adult; Endemic region; Female; Goiter, Nodular - drug therapy; Goiter, Nodular - surgery; Humans; Male; Middle Aged; Multinodular goiter; Postoperative Care; Recurrence; Thyroid Function Tests; Thyroidectomy; Thyroxine; Thyroxine - therapeutic use
• ISSN: 0918-8959; 1348-4540
• DOI: 10.1507/endocrj.47.349

In this study, we investigated the value of thyroxine administration to prevent recurrence after bilateral subtotal thyroidectomy for multinodular goiter. Patients that had benign multinodular goiter were operated on with the same surgical principles: ligation of both superior and inferior thyroid arteries on both sides, bilateral subtotal resection of thyroid gland including all visible nodules. On the 3rd postoperative day, the patients were divided into two groups: with 100 microgram 1-thyroxine daily (Thyroxine group) or no therapy (Control group). No recurrences were encountered among 40 patients followed up for 6 months and 20 patients for at least one year. One patient in the control group developed manifest hypothyroidism (5.3%). The mean TSH level of the control group was significantly higher than that of thyroxine group at 1st, 2nd, 3rd, 4th, 5th, 6th, and 12th months. At the end of the first year, the mean TSH level of the control group was four times that of the normal. On the other hand, the mean TSH level of the thyroxine group was within normal limits but not suppressed. In conclusion, we found that the pituitary-thyroid axis did not become normal spontaneously one year after thyroidectomy. Therefore, postoperative thyroxine administration seems to be of value, especially in endemic regions like Turkey.