title: Should subtotal thyroidectomy be abandoned in multinodular goiter patients from endemic regions requiring surgery?
abstract: The most convenient surgical procedure for benign thyroid diseases is still controversial. The aim of this study is to determine the recurrence rate and risk factors for recurrence after different thyroidectomy procedures in multinodular goiter patients. Patients were separated into two groups according to the detection of a recurrent nodule or not after thyroidectomy. Of the 748 patients, 216 (29%) had recurrence, while 532 had no recurrent nodule. The difference between surgical procedures described as subtotal (ST), near total (NT) and total thyroidectomy (TT) was statistically significant. Transient hypoparathyroidism was significantly higher in NT and TT, when compared to ST patients (P < 0.05). Young age, bilateral multinodular goiter and insufficient surgery are risk factors affecting recurrence for benign nodular thyroid disease. Currently, subtotal procedures should be discontinued and total or near total procedures should be preferred. Meanwhile, the probability of a higher risk of hypoparathyroidism should be kept in mind.
authors.affiliation: 1 School of Medicine, Department of General Surgery, Division Endocrine Surgery, Ege University, Izmir, Turkey.
authors.forename: Tayfun
authors.initials: T
authors.lastname: Yoldas
authors.forename: Ozer
authors.initials: O
authors.lastname: Makay
authors.forename: Gokhan
authors.initials: G
authors.lastname: Icoz
authors.forename: Timur
authors.initials: T
authors.lastname: Kose
authors.forename: Gulten
authors.initials: G
authors.lastname: Gezer
authors.forename: Erkan
authors.initials: E
authors.lastname: Kismali
authors.forename: Sadık
authors.initials: S
authors.lastname: Tamsel
authors.forename: Sureyya
authors.initials: S
authors.lastname: Ozbek
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yılmaz
authors.forename: Mahir
authors.initials: M
authors.lastname: Akyildiz
mesh_terms: D000328:Adult; D019353:Endemic Diseases; D005260:Female; D005500:Follow-Up Studies; D006044:Goiter, Nodular / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology
keywords: Multinodular goiter; Recurrence classification description: Endocrinology; Thyroidectomy