Safety and Effectiveness of Total versus Subtotal Thyroidectomy in Management of Simple Multinodular Goiter

Abstract

isorders of the thyroid gland constitute the second most common endocrine disease following diabetes mellitus. The prevalence of nodular goiter and thyroid autonomy is increased in regions with chronic Iodine Deficiency (ID). It has been documented that the thyroid gland adjusts to ID in the early stages by diffuse hyperplasia, while chronic exposure to ID results in nodular hyperplasia, increased colloid content and increased height of the follicular cells. Multinodular goiter is a common clinical problem that usually develops during the late stage of goiter. Although it is usually benign and asymptomatic in nature, multinodular goiter may predispose the patient to compressive symptoms, develops autonomous functioning nodules, or form suspicious nodules. The clinical treatment of goiter depends on the extent of enlargement, signs and symptoms, and potential underlying causes. Thyroidectomy methods range from Subtotal to total thyroidectomy (TT) in benign thyroid disorders. TT and bilateral subtotal thyroidectomy (BST) are the most commonly preferred methods by surgeons for MNG. The selected surgical method for thyroid disease should aim to eradicate the disease as well as to minimize postoperative complications. The thyroid extends from the level of the fifth cervical vertebra to the first thoracic vertebra. It concists of 2 lateral