Mahmud Aurangzeb, Shaukat Hayat.
Total Thyroidectomy for benign bilateral multinodular goitre in an endemic region.
Pak J Surg Jan ;22(4):195-200.

Objective: To assess the safety and efficacy of total thyroidectomy as the primary treatment modality for all patients presenting with a benign bilateral multinodular goitre and to highlight its importance in an endemic region. Design & Duration: A retrospective study from June 1998 to December 2005. Setting: Department of Surgery, Khyber Teaching Hospital, Peshawar. Patients: 106 patients who underwent total thyroidectomy for bilateral benign multinodular goitre. Methodology: The data of all the above mentioned patients was recorded and analyzed. Results: Amongst the total 106 patients, the female to male ratio was 5:1. Most patients were euthyroid biochemically. The most common indication for thyroidectomy was compressive symptoms. In the vast majority of patients the final diagnosis was benign adenomatous colloid goitre; the incidence of occult carcinoma was 8.4%. The incidence of permanent unilateral recurrent laryngeal nerve injury and permanent hypoparathyroidism was 1.8% and 0.9% res- pectively. There were no postoperative deaths in this series. Conclusion: The results of this study confirms the safety and efficacy of total thyroidectomy for all patients presenting with bilateral multinodular goitre. This is particularly relevant in endemic regions, where patients present with large, longstanding goitres, which grossly involve both lobes, with virtually no normal thyroid tissue. This approach avoids disease recurrence and the increased morbidity associated with secondary operations.

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