Total Thyroidectomy in Multinodular Goiter: An African Experience

Moussa Abdoulaye Ouattara^1*, Seydou Togo¹, Ibrahima Sankaré¹, Kadiatou Singaré², Sekou Koumaré³, Issa Maiga¹, Allaye Ombotibé¹, Jacques Saye¹, Assa Traoré⁴, Nouhoum Diani⁵, Zimogo Ziè Sanogo³, Sadio Yena¹

¹Department of Thoracic Surgery, Hospital of Mali, Bamako, Mali.
²Department of Otorhinolaryngology, Gabriel Touré Teaching Hospital, Bamako, Mali.
³Department of General Surgery “A”, Point G Teaching Hospital, Bamako, Mali.
⁴Department of Endocrinology, Hospital of Mali, Bamako, Mali.
⁵Department of Anesthesia, Hospital of Mali, Bamako, Mali.

DOI: 10.4236/ss.2015.612075                

Abstract

Introduction: Total thyroidectomy is an operation that involves the surgical removal of the whole thyroid gland, with the preservation of the parathyroid glands. The aim of the present study was to assess the complication rates of total thyroidectomy on benign indication and first-time thyroid surgery and investigate the early outcome after opotherapy. Materials and Methods: In this retrospective study, patients who underwent total thyroidectomy for benign multinodular goiter in the department of thoracic surgery in our Hospital from January 2012 to December 2014 were included. In postoperative time, we evaluated surgical complication, histopathological examination and opotherapy. Results: A total 53 patients underwent total thyroidectomy for multmodular goiter; they were 49 (92.45%) bilateral and 4 (7.55%) unilateral (recurrence). The mean age was 47 years and mean diameter of goiter was 10.75 cm. Among the patients 88.68% were females and 11.32% were male. Preoperative hormonal statuses were (70%) in euthyroid and (30%) hyperthyroid following surgery complications like transient laryngeal nerve palsy (3.77%), transient hypocalcemia (7.55%), hematoma (1.9%) and wound infection (1.9%). On histopathological examination of the surgical specimen, 5.7% were reported to be malignant. Six month following surgery 92.45% of patients was a good hormonal balance. Conclusion: Total thyroidectomy for multinodular goiter has a low morbidity and mortality; this procedure olves both the problem of recurrence of disease and reintervention. The opotherapy is doable with a good hormonal balance.

Keywords

Multi-Nodular Goiter, Total Thyroidectomy, Complication

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Francis, S. and Green, S. (1991) Endocrine Disorders. Medical Clinics of North America, 75, 195-206.
[2]	Bononi, M., De Cesare, A., Atella, F., Angelini, M., Fierro, A. and Fiori, E. (2000) Surgical Treatment of Multinodular goiter: Incidence of Lesions of the Recurrent Nerves after Total Thyroidectomy. International Surgery, 85, 190-193.
[3]	De Roy van Zuidewijn, D.B., Songun, I. and Kievit, J. (1995) Complications of Thyroid Surgery. Annals of Surgical Oncology, 2, 56-60. http://dx.doi.org/10.1007/BF02303703
[4]	Lombardi, C.P., Raffaelli, M. and De Crea, C. (2007) Complications in Thyroid Surgery. Minerva Chirurgica, 62, 395-408.
[5]	Touré, A., Diallo, A.T., Camara, L.M., Touré, F.B. and Camara, N.D. (2006) La chirurgie thyroidienne: Experience du service de chirurgie générale du CHU Ignace Deen de Conakry. Mali Médical, 21, 24-27.
[6]	Sanogo, Z.Z., Koita, A.K., Koumaré, S., Saye, Z., Keita, S., Camara, M., Doumbia, D., Ouattara, M., Togo, S., Yéna, S. and Sangaré, D. (2012) Prise en charge chirurgicale des goitres hyperthyroidiens à Bamako. Mali Médical, 26, 1-4.
[7]	Ozbas, S., Kocak, S. and Aydintug, S. (2005) Comparison of the Complications of Subtotal, Near Total and Total Thyroidectomy in the Surgical Management of Multinodular Goiter. Endocrine Journal, 52, 199-205. http://dx.doi.org/10.1507/endocrj.52.199
[8]	Alimoglu, O., Akdag, M. and Sahin, M. (2005) Comparison of Surgical Techniques for Treatment of Benign Toxic Multinodular Goiter. World Journal of Surgery, 29, 921-924. http://dx.doi.org/10.1007/s00268-005-7767-3
[9]	Bhattacharyya, N. and Fried, M.P. (2002) Assessment of the Morbidity and Complications of Total Thyroidectomy. Archives of OtolaryngologyHead & Neck Surgery, 128, 389-392. http://dx.doi.org/10.1001/archotol.128.4.389
[10]	Ciftci, F., Sakalli, E. and Abdurrahman, I. (2015) Total versus Bilateral Subtotal Thyroidectomy for Benign Multi-Nodular Goiter. International Journal of Clinical and Experimental Medicine, 8, 4596-4600.
[11]	Godazandeh, G., Kashi, Z., Godazandeh, F., et al. (2015) Influence of Thyroidectomy on Postoperative Serum Calcium Level Regarding Serum Vitamin D Status. A Prospective Study. Caspian Journal of Internal Medicine, 6, 72-76.
[12]	Koyuncu, A., Dokmetas, H.S. and Turan, M. (2003) Comparison of Different Thyroidectomy Techniques for Benign Thyroid Disease. Endocrine Journal, 50, 723-727. http://dx.doi.org/10.1507/endocrj.50.723
[13]	Tezelman, S., Borucu, I., Senyurek Giles, Y., Tunca, F. and Terzioglu, T. (2009) The Change in Surgical Practice from Subtotal to Near-Total or Total Thyroidectomy in the Treatment of Patients with Benign Multinodular Goiter. World Journal of Surgery, 33, 400-405. http://dx.doi.org/10.1007/s00268-008-9808-1
[14]	Friguglietti, C.U., Lin, C.S. and Kulcsar, M.A. (2003) Total Thyroidectomy for Benign Thyroid Disease. Laryngoscope, 113, 1820-1826. http://dx.doi.org/10.1097/00005537-200310000-00030
[15]	Siragusa, G., Lanzara, P. and Di Pace, G. (1998) Subtotal Thyroidectomy or Total Thyroidectomy in the Treatment of Benign Thyroid Diseases. Our Experience. Minerva Chirurgica, 53, 233-238.
[16]	Sanjeeva, K.K., Chandra, B., Balakrishna, M.A., et al. (2015) Clinico-Epidemiological Study and Treatment Outcome of Multinodular Goitre at a Tertiary Care Hospital. Journal of Clinical and Diagnostic Research, 9, 22-25.
[17]	Uccheddu, A., Cois, A. and Licheri, S. (1996) The Choice of the Intervention in the Surgical Treatment of Nontoxic Diffuse Multinodular Goiter. Minerva Chirurgica, 51, 25-32.
[18]	Rodier, J.F., Strasser, C. and Janser, J.C. (1990) Thyroid Function after Thyroidectomy for Benign Goiter. 200 Cases Explored by Ultrasensitive TSH. Journal de Chirurgie (Paris), 127, 445-451.