Subtotal thyroidectomy for benign multinodular goiter: a 6-month postoperative study of the remnant's function and sonographic aspect.
BACKGROUND
The purpose was to evaluate the thyroid function after subtotal thyroidectomy.


METHODS
One hundred and nineteen patients operated on for multinodular benign goiter were included in this prospective study. Results of the surgical treatment were evaluated 6 months after operation by thyroid-stimulating hormone (TSH) assay and cervical echography.


RESULTS
Thyroid-stimulating hormone levels correlated inversely (r=-0.78) with the thyroid remnant volumes. Forty-seven patients presented with a hypoechoic aspect of the remnant. Isoechoic and hypoechoic remnant volumes were similar; however, 46 of the 47 patients with a hypoechoic remnant (97.9%) had TSH levels higher than 5 mU/l vs. 39 of the 72 patients (54.2%) with an isoechoic aspect. No predictive factor for the occurrence of this hypoechoic feature was found.


CONCLUSIONS
After sub-total thyroidectomy for benign multinodular goiter, the volume of the remnant is not the only determinant of the occurrence of postoperative hypothyroidism. The appearance of a hypoechoic aspect of the remnant is also a strong predictive factor for such an outcome. In this case the occurrence of hypothyroidism is quite constant whatever the volume of the thyroid remnant. Since this evolution toward a hypoechoic aspect of the remnant is unpredictable, our results are an additional argument in favor of total thyroidectomy for benign multinodular goiter.
Bakiri
Fawzy
F
Service d'Endocrinologie, Hôpital Bologhine, Bains-Romains, 16060 Algiers, Algeria. f.bakiri@chd-fguyon.fr
Hassaïm
Menad
M
Bourouba
Mohamed-Sadreddine
MS
D000328:Adult; D000368:Aged; D005260:Female; D006044:Goiter, Nodular / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007037:Hypothyroidism / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000000981:diagnostic imaging; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods; D013972:Thyrotropin / Q000097:blood; D014463:Ultrasonography
D013972:Thyrotropin