NEAR TOTAL THYROIDECTOMY FOR THE SURGICAL TREATMENT OF MULTI NODULAR GOITER IN AN ENDEMIC REGION

Abstract

The aim of this study is to point out an efficient surgical treatment for multi nodular goiter in endemic regions with minimal morbidity. In the surgical treatment of multi nodular goiters in endemic regions morbidity and recurrent nodular goiter are the major problems. In order to solve these problems various kinds of surgical procedures has been used; total thyroidectomy eliminates the potential risk of reoperation but this procedure has a more morbidity rate and also the patients need thyroxine supplementation during whole life. In this study we evaluate the early results and postoperative morbidity of the 76 patients with multi nodular goiter which are treated surgically. Female/male ratio was 3/1 (56/20) and mean age was43.53 (24-75) years in the series. 35 patients (%46) had hyperthyroidy. We perform a total lobectomy on the dominant nodule side with isthmectomy and a near total conterlateral lobectomy on the other lobe. There were no postoperative deaths, 5 complications occurred during 76 operations (% 6.5). There was no permanent complication (%0). In two patients transient hypoparathyroidism in two patients transient recurrent laryngeal nerve palsy and in one patient hematoma occurred. There were no wound infection and seroma. in the surgical treatment of multinodular goiter in endemic regions near total thyroidectomy is an effective surgical procedure with low morbidity.