title: Is hemithyroidectomy a rational management for benign nodular goitre? A Multicentre Retrospective Single Group Study.
abstract: BACKGROUND
  The incidence and potential risk factors for the recurrence of benign nodular goitre after unilateral thyroidectomy are not clearly defined. The aim of this study was to assess the rate of progression of nodular goitre in the contralateral thyroid lobe and of hypothyroidism requiring replacement therapy after unilateral thyroid lobectomy for benign nodular goitre.
  
  
  METHODS
  Patients who underwent hemithyroidectomy for benign nodular goitre between 2000 and 2009 were included in the study. The primary outcome of this study was the reoperation rate for recurrent goitre, the rate of progression of nodular goitre and the rate of hypothyroidism requiring L-T4 replacement therapy. Clinical factors that have an effect on progression were further analysed.
  
  
  RESULTS
  259 patients were included for study. Progression of the nodular goitre in the remnant lobe was observed in 32% (n = 83) of the patients. However, over time, only 2% of these 83 patients underwent contralateral hemithyroidectomy due to this progression. Fifty-six (22%) patients required L-thyroxin replacement due to persistent hypothyroidism after hemithyroidectomy. The factors shown to affect progression of nodular goitre were advanced age, preoperative hyperthyroidism, preoperative diagnosis of toxic nodular goitre and the presence of surgical indication for a toxic goitre causing hyperthyroidism and a definitive pathological diagnosis of nodular hyperplasia.
  
  
  CONCLUSIONS
  There was a progression of the nodular goitre in the remnant lobe in about one-third of the patients who underwent hemithyroidectomy. However, only 2% of these patients underwent complementary contralateral hemithyroidectomy due to clinical progression in 31 months of follow-up.
authors.affiliation: Department of General Surgery, Marmara University School of Medicine, Istanbul, Turkey, Department of Surgery, Ankara Training and Research Hospital, Ankara, Turkey, Department of General Surgery, Kocaeli University School of Medicine, Kocaeli, Turkey, Istanbul Faculty of Medicine, Surgery Unit E, Istanbul University, Istanbul, Turkey, Department of General Surgery, Gulhane Military Medical Academy, Ankara, Turkey, Department of Surgery, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey, Department of General Surgery, Dokuz Eylul University School of Medicine, Izmir, Turkey, Department of General Surgery, Maltepe University School of Medicine, Istanbul, Turkey, Department of General Surgery, Adnan Menderes University School of Medicine, Aydin, Turkey, *corresponding author: tel.: +90 2166570606, fax: +90 2166570695, email: drwafi2003@yahoo.com.
authors.forename: W
authors.initials: W
authors.lastname: Attaallah
authors.forename: S
authors.initials: S
authors.lastname: Erel
authors.forename: N Z
authors.initials: NZ
authors.lastname: Canturk
authors.forename: Y
authors.initials: Y
authors.lastname: Erbil
authors.forename: S
authors.initials: S
authors.lastname: Gorgulu
authors.forename: H
authors.initials: H
authors.lastname: Kulacoglu
authors.forename: M A
authors.initials: MA
authors.lastname: Kocdor
authors.forename: A
authors.initials: A
authors.lastname: Kebudi
authors.forename: S
authors.initials: S
authors.lastname: Ozbas
authors.forename: B M
authors.initials: BM
authors.lastname: Gulluoglu
mesh_terms: D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006044:Goiter, Nodular / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome