Is Goiter is an Endemic Problem | Thyroidectomy
Journal of Thyroid Disorders & Therapy offers the most comprehensive and reliable information pertaining to the latest developments in the field. The Journal also believes in advancing new hypotheses and opinions by means of its high quality Reviews, Perspectives, and Commentaries. Thus, the content published in the journal is original and comprehensive.
Extent of thyroidectomy has always been a highly debated topic among thyroid surgeons, regardless of whether it is performed for a benign or malignant thyroid condition. Although lobectomy or subtotal thyroidectomy have long been favored because they have always been perceived as a procedure resulting in fewer recurrent laryngeal nerve (RLN) injuries, hypocalcemia and hemorrhage/ hematoma than total thyroidectomy, over the last 10-15 years, many surgeons have preferred doing a total thyroidectomy when the disease has involved both thyroid lobes (i.e. bilateral multinodular goiter). Нe rationale behind this change is the fact that with improving surgical techniques and experience, total thyroidectomy can be performed as safely as lobectomy or subtotal thyroidectomy. Furthermore, total thyroidectomy virtually eliminates the future risk of remnant recurrence and risky reoperations.
In a large retrospective analysis of over 2000 patients who either had a total thyroidectomy or bilateral subtotal thyroidectomy, the authors found the latter procedure resulted in a significantl\ higher rate of completion thyroidectomy while the rate of permanent complications was not significantl\ diوٴerent between the two procedures . Based on these findings they recommended total thyroidectomy for bilateral multinodular goiter to prevent recurrence and to eliminate the necessity for early completion thyroidectomy in case of a final diagnosis of thyroid carcinoma. However, in the recent few years, this practice of doing routine total thyroidectomy has been increasingly questioned.
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