Total Thyroidectomy for Benign Thyroid Disease: A Prospective Study

Background: The extent of thyroidectomy (subtotal to total) for benign thyroid disease was controversial till recent times. Theoretically, total thyroidectomy is a logical and optimal surgical procedure for benign thyroid disease affecting the entire thyroid gland as it has the advantage of immediate and permanent cure with no recurrence. Total thyroidectomy is currently the preferred treatment for benign thyroid disease. However, practically surgeons choose to avoid it and stick on to subtotal thyroidectomy due to the risk of damage to surrounding vital structures (parathyroids and recurrent laryngeal nerve [RLN]). Aim of the Study: To evaluate the efficacy and safety of total thyroidectomy in the management of benign thyroid disease in terms of permanent complications, i.e., Hypoparathyroidism and RLN palsy. Methodology: This prospective study was conducted on 236 patients in surgical unit of Mahatma Gandhi Memorial Hospital, Kakatiya Medical Collage, Warangal, Telangana, India, from October 2010 to November 2015. Patients with benign thyroid disease were operated with total thyroidectomy and results were analyzed. Results: About 222 patients were without any post-operative complications (94.06%), and 15 patients were with different post-operative complications (6.35%). Six patients presented with post-operative transient hypocalcemia (2.54%). One patient remained as permanent hypoparathyroidism (0.42%). Two patients developed permanent unilateral RLN palsy (0.84%). One Patient developed hematoma due to reactionary hemorrhage (0.42%). No patient developed permanent bilateral RLN palsy (0%) and there was no mortality (0%). Conclusion: Total thyroidectomy if performed by experienced surgeons is quite safe and preferred option for management of benign thyroid disease to avoid future re-occurrences.