The Optimal Amount of Residual Thyroid Tissue Following Subtotal Thyroidectomy

Abstract

Multinodular goiter is one of the commonest thyroid tissue disorders in our surgical practice; the standard treatment of multinodular goiter is subtotal thyroidectomy. A lot of controversies exist, in the exact amount of residual thyroid tissue after surgery and the role of L-Thyroxin post operatively in the prevention of thyroid recurrence.

The study included 21 patients with goiter, all were females. Estimation of sT3, sT4, sTSH, preoperative ultrasound and thyroid scan were done. A standardized subtotal thyroidectomy technique was performed for all patients. Follow up estimation ofTSH, residual thyroid volume by ultrasound and by thyroid scan was performed after two weeks and three months respectively after operation. A residual ultrasound index and thyroid scan index were proposed and estimated.

Our results showed that there was no significant change in the level of sTSH all over the period with any significant change in the residual thyroid volume without administrating suppressive dose of L-Thyroxin postoperatively. Moreover, thyroid scan volumes proved to be of major value in the evaluation of patients with toxic goiter.

The proposed ultrasound anatomical index as well as the thyroid scan functional index are feasible and could be used as an independent parameter in the follow up of patients under going subtotal thyroidectomy.