Is Total Thyroidectomy the Optimal Treatment for Benign Thyroid Disease?
| Autor: | Tanio Ivanov Sechanov, Manol Kalniev, Kalin Vidinov |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Total thyroidectomy
endocrine system medicine.medical_specialty Multidisciplinary endocrine system diseases business.industry Incidence (epidemiology) Graves' disease Thyroid disease Thyroid medicine.disease Surgery medicine.anatomical_structure medicine Hypocalcaemia Complication business Thyroid cancer |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 1310-1331 |
| DOI: | 10.7546/cr-2013-66-7-13101331-19 |
| Popis: | Benign bilateral thyroid disease is the most common indication for surgery in endemic iodine-deficiency regions. Total thyroidectomy is currently the preferred treatment for thyroid cancer, multinodular goiter and Graves disease; however, many surgeons and endocrinologists choose not to perform or recommend total thyroidectomy to treat benign thyroid diseases. We sought to assess whether the results support the hypothesis that total thyroidectomy is safe and can be considered as the optimal surgical approach for treating BTD in endemic region such as Bulgaria. A total of 500 patients underwent thyroid operation between 2007 and 2009. We excluded patients with thyroid cancer or suspicion of thyroid malignancy. We evaluated indications for total thyroidectomy, complication rates, local recurrence rate and long-term outcome after total thyroidectomy. Diagnoses before surgery were multinodular goiter (n = 300), Graves disease (n = 100) and Toxic multinodular goiter (n = 100). The incidence of permanent bilateral recurrent laryngeal nerve palsy was 0% and that of permanent unilateral recurrent laryngeal nerve palsy and permanent hypocalcaemia was 1.8–5%. Haemorrhage requiring repeated surgery occurred in 4.5–13% of patients. There was no wound infection, and postoperative mortality was 0%. Total thyroidectomy is safe and is associated with a low incidence of disabilities. Furthermore, our study showed that total thyroidectomy is the optimal procedure, when surgery is indicated, for Graves disease and toxic multinodular goiter, as total thyroidectomy has the advantages of immediate and permanent cure and no recurrences. |
| Databáze: | OpenAIRE |
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