Reoperative surgery for bilateral multinodular goitre in the era of total thyroidectomy

Background: Total thyroidectomy, rather than bilateral subtotal thyroidectomy, is now accepted as the preferred management for bilateral benign multinodular goitre (BMNG) in order to reduce the need for reoperative surgery. The aim of this study was to examine whether this approach has had an impact...

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Bibliographic Details
Published in:British journal of surgery Vol. 99; no. 5; pp. 688 - 692
Main Authors: Vasica, G., O'Neill, C. J., Sidhu, S. B., Sywak, M. S., Reeve, T. S., Delbridge, L. W.
Format: Journal Article
Language:English
Published: Chichester, UK John Wiley & Sons, Ltd 01.05.2012
Wiley
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Child
Child, Preschool
Cohort Studies
Female
General aspects
Goiter, Nodular - surgery
Humans
Male
Medical sciences
Middle Aged
Postoperative Complications - surgery
Recurrence
Reoperation - statistics & numerical data
Retrospective Studies
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of endocrine glands
Thyroidectomy - methods
Young Adult
Medicine
Bilateral
Treatment
Thyroidectomy
Surgery
ISSN:0007-1323, 1365-2168, 1365-2168
Online Access:Get full text
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Summary:Background: Total thyroidectomy, rather than bilateral subtotal thyroidectomy, is now accepted as the preferred management for bilateral benign multinodular goitre (BMNG) in order to reduce the need for reoperative surgery. The aim of this study was to examine whether this approach has had an impact on presentation for bilateral reoperative thyroid surgery. Methods: This was a retrospective cohort study. The study group comprised patients presenting with recurrent BMNG who underwent bilateral reoperative thyroid surgery following previous bilateral subtotal or partial thyroidectomy. They were compared with patients undergoing unilateral reoperative thyroid surgery following previous lobectomy, and those undergoing primary total thyroidectomy for BMNG. Results: Between 1 January 1987 and 31 December 2009, 12 354 consecutive thyroid procedures were undertaken. Among those with BMNG, primary total thyroidectomy was undertaken in 3298 patients, unilateral reoperative thyroidectomy in 337 and bilateral reoperative thyroidectomy in 191. Presentations of patients with recurrent BMNG declined gradually over the study period following the change in policy from subtotal to total thyroidectomy; only five patients (representing less than 0·5 per cent of all thyroid surgery) underwent bilateral reoperative surgery for BMNG in the last year of the study. Four of these patients had their initial operation before 1987 and in another unit, whereas the remaining patient initially had surgery overseas. Conclusion: The introduction of a policy of initial total thyroidectomy for bilateral BMNG has essentially eliminated the need for bilateral reoperative surgery for recurrent goitre. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Has eliminated the need for reoperation
Bibliography:istex:EE2B16CFBDC4AAE873FA6A1E8A6509773F97EDBA
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ArticleID:BJS8684
ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
content type line 23
ISSN:0007-1323
1365-2168
1365-2168
DOI:10.1002/bjs.8684