Thyrotoxicosis--surgical management in the era of evidence-based medicine: experience in western India with 752 cases

Experience of thyroid surgery at tertiary referral centers in Jazan Hospitals, Saudi Arabia

Background

Benign multinodular goiter (BMNG) is a common disease of the thyroid gland with palpable thyroid nodules that may be detected in 0.8%–1.5% of men and 5.3%–6.4% of women. Three major complications could be detected after total thyroidectomy: hemorrhage, recurrent laryngeal paralysis, and hypoparathyroidism.

Aims

The aim of this study was to review and assess the experience of total thyroidectomy in patients with BMNG at tertiary referral centers in Jazan Hospitals, Saudi Arabia.

Methods

A retrospective study was conducted on 320 patients diagnosed with BMNG and subjected to primary total thyroidectomy. Operative mortality and major complications [bleeding, recurrent laryngeal nerve (RLN) injury, and hypoparathyroidism] were recorded.

Results

Postoperative hemorrhage was reported in four patients (1.25%). Bilateral RLN injuries occurred in two patients (0.6%), whereas unilateral RLN injuries occurred in nine patients (2.8%). Permanent hypoparathyroidism was diagnosed in three patients (0.9%), while transient hypoparathyroidism occurred in eight patients (2.5%) and improved after 4 months.

Conclusions

Total thyroidectomy represents today the treatment of choice for BMNG. Proper preoperative preparations, meticulous surgical dissection with careful follow-up of patients will improve the surgical results and reduce postoperative complications.