[Non-toxic multinodular goitre: which surgery?].
OBJECTIVE
Evaluation of total thyroidectomy, subtotal thyroidectomy and lobectomy in the management of multinodular non-toxic goitre.


METHODS
225 patients: 101 total thyroidectomies, 64 sub-total thyroidectomies, 29 lobo-hystmectomies. Hemorrages, recurrent nerve palsies, post-operatory hypocalcemias, clinical and ultrasonographic relapses, undesired effects of ormonal therapy and hypothyroidism after partial resection (considered risk factor for recurrence) have been pointed out.


RESULTS
All three procedures showed a low incidence of recurrent nerve palsy; lobectomy didn't show post-operatory hypocalcemia, that appeared respectively in 26.6% and 23% after sub-total and total thyroidectomy. Recurrence's percentage in patients followed-up, was 18.2% after lobectomy and 12.2% after sub-total thyroidectomy, but in that group we observed 46.9% of hypothyroidism (vs. 9.1% after lobectomy) and 8.6% of undesired effects of therapy. Reoperations showed inferior laringeal palsy and post-operatory hypocalcemia significantly more elevated.


CONCLUSIONS
Compared to lobectomy, total thyroidectomy showed higher risk of hypoparathyroidism; compared to subtotal thyroidectomy, it showed on all occasions less incidence of complications. Endocrinological follow-up is easier after total thyroidectomy.


CONCLUSIONS
According to our results, we deem the indications for lobectomy have to be limited to the patients having solitary nodule, undoubtedly benign, without familiarity or other environmental risk factor of goitre.
Scerrino
G
G
Dipartimento di Chirurgia Generale d'Urgenza Divisione di Chirurgia Generale, d'Urgenza, dei Trapianti e dell'Uremico, Università di Palermo.
Salamone
G
G
Farulla
M A
MA
Romano
G
G
Salamone
S
S
Pompei
G
G
Buscemi
G
G
D000328:Adult; D000368:Aged; D005260:Female; D006044:Goiter, Nodular / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013965:Thyroidectomy / Q000379:methods*
Il gozzo multinodulare non tossico: quale chirurgia?