Total thyroidectomy in management of benign thyroid disease

Abstract

Background: The use of total thyroidectomy in benign thyroid disease treatment is not universal. A total of 60 total thyroidectomies performed for benign thyroid diseases. The Aim of the study was to evaluate the role of total thyroidectomy in patients with presumed bilateral benign thyroid disease, with special emphasis on the incidence of two major post-operative complications namely hypoparathyroidism and recurrent laryngeal nerve palsy. Methods: It was a prospective study, A total of 60 patients who underwent total thyroidectomy for benign thyroid diseases between January 2016 to January 2018 were studied in department of general surgery at St Martha’s hospital, Bangalore. The patients were followed up for a period of nine months for post-operative complications. Results: Most of the patients were in the fifth decade of life, Female outnumbered males. Female: male ratio was 4.5:1. Amongst the 60 patients in the present study, the incidence of transient recurrent unilateral laryngeal nerve palsy was seen in 5 %, temporary hypocalcemia in 20%, permanent hypocalcemia in 3.3%, and permanent unilateral laryngeal nerve palsy in 1.66%. Malignancy detected after histopathological examination was in 8.33% of the patients. There was no wound infection, hematoma, bilateral RLN palsy and post-operative mortality. Conclusion: Total thyroidectomy for benign thyroid disease can eliminate any subsequent risk of malignant change in thyroid glands. A low complication rate can be achieved with meticulous surgical technique. Total thyroidectomy can be performed safely and can be considered as valuable option for treating benign bilateral thyroid diseases.