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COMPARISON OF OUTCOME OF TOTAL VERSUS SUBTOTAL THYROIDECTOMY FOR THE TREATMENT OF MULTINODULAR GOITER

Dr Ayesha Marium, Dr. Faryal Ahmed, Dr Hafiza Khadija Azhar

Objective: The aim of this study was to compare the outcomes of total and subtotal thyroidectomy (STT) for benign bilateral multinodular goiter in terms of recurrent laryngeal nerve paralysis (RLNP) and hypoparathyroidism. Study design: A quasi-experimental study. Place and Duration: In the Surgical department of Holy Family Hospital Rawalpindi for one year duration from March 2018 to March 2019. Methods: 60 total volunteers with bilateral multinodular goiter were divided into 2 groups as A and B (30 patients in each group). Total thyroidectomy was done in group A patients and patients under STT in B group. The non-probability purposive sample technique was used. Demographic details, operation indications, biochemical results, complications and duration of surgery were observed for each group. Results: There was no noteworthy variation between the two groups in terms of sex, age, hormonal status or goiter duration (P = 0.74, P = 0.123, P = 0.509 and P = 0.6, correspondingly). The mean working time for TTT and STT was longer (138 ± 30 min, 112 ± 33 min, P = 0.046). Transient RLNP or HPT occurred in 3 (9.9%) or 6 (20%) of 6 patients, in 3 (6.6%) or 3 (9.9%) patients undergoing STT (P = 0.64). and P = 0.278, respectively). Permanent RLNP was noted in none of the patients in the TT group and in HPT compared to none of the complications in the STT group (P = 0.313 for persistent HPT). Conclusions: This study demonstrates that TT can be achieved without raising the risk of complications and is taken as substitute for benign MNG, mainly in endemic areas with very large multinodular goiter. Keywords: bilateral benign multinodular goiter, total thyroidectomy, subtotal thyroidectomy, hypoparathyroidism, and recurrent laryngeal nerve palsy.

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