title: Total thyroidectomy for the surgical treatment of multinodular goiter.
abstract: OBJECTIVE
  The indications for surgical treatment of multinodular goiter (MNG) are pressure symptoms, suspicion of malignancy, and cosmetic concerns. We report our clinical experience of performing total thyroidectomy (TT) for MNG, focusing on outcome and complications, to evaluate its effectiveness.
  
  
  METHODS
  The medical records of 154 patients who underwent TT for MNG between 2005 and 2007 were reviewed retrospectively. We examined the ratio of thyroid nodules to the thyroid gland, pathological fine-needle aspiration biopsy findings, and the ultrasonographic characteristics of the nodules, and recorded the early and late postoperative complications.
  
  
  RESULTS
  The most frequent indications for surgery were large nodules with or without radiological suspicion of malignancy (65%), hyperthyroidism (20%), and cosmetic problems or compression symptoms (15%). Seventeen (11%) patients had symptomatic, transient hypocalcemia, and 1 (0.6%) had permanent hypocalcemia. Other complications included hematoma in 1 (0.6%) patient, temporary unilateral recurrent laryngeal nerve palsy in 10 (6.4%), permanent unilateral recurrent laryngeal nerve palsy in 3 (1.9%), and seroma in 2 (1.3%). There was no significant relationship between complications and histopathology, nodule size, thyroid size, hyperthyroidism, age, or gender.
  
  
  CONCLUSIONS
  Total thyroidectomy is the right surgical decision for MNG since it achieves complete remission of symptoms and eliminates malignancy, with low morbidity and mortality rates.
authors.affiliation: Department of Surgery, Ankara Oncology Education and Research Hospital, Ankara, Turkey.
authors.forename: Lutfi
authors.initials: L
authors.lastname: Dogan
authors.forename: Niyazi
authors.initials: N
authors.lastname: Karaman
authors.forename: Kerim Bora
authors.initials: KB
authors.lastname: Yilmaz
authors.forename: Cihangir
authors.initials: C
authors.lastname: Ozaslan
authors.forename: Can
authors.initials: C
authors.lastname: Atalay
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006044:Goiter, Nodular / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D013965:Thyroidectomy / Q000379:methods*; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult