Surgical Treatments for Multinodular Goiter Compared

In a study reported on in the April 2005 issue of Endocrinology Journal, researchers compared the complication rates of various types of thyroid surgery, as a treatment for benign multinodular goiter.

• bilateral subtotal thyroidectomy (BST), taking of partial thyroid on both lobes
• near total thyroidectomy (NTT) -- almost complete removal of the entire thyroid
• total thyroidectomy (TT) -- complete removal of the entire thyroid

750 patients receiving surgery for benign multinodular goiter were followed for an average of more than four years. No patients died in the group studied.

After bilateral subtotal thyroidectomy...

• 8.2% of patients developed developed transient hypocalcaemia (deficiency in calcium)
• 2.4% had transient recurrent laryngeal nerve (RLN) palsy.
• .6% had RLN palsy.

After near total thyroidectomy

• 12.2% developed transient hypocalcaemia
• .6% had transient voice disturbances

No patients had any permanent complications.

Total thyroidectomy

• 30% had transient hypocalcaemia
• .4% suffered permanent hypoparathyroidism
• 1.9% had temporary recurrent laryngeal nerve (RLN) palsy injury (but none remained permanent)

Of all the patients studied, only 2 had recurrences of benign multinodular goiter, and those were patients who had the bilateral subtotal thyroidectomy.

Permanent complication rates were similar for all three surgeries, and so given the recurrence associated with the bilateral subtotal thyroidectomy, the near total thyroidectomy or total thyroidectomy may be the operation of choice for multinodular goiter.

Source: Ozbas S, et. al. "Comparison of the complications of subtotal, near total and total thyroidectomy in the surgical management of multinodular goitre." Endocr J. 2005 Apr;52(2):199-205