TOTAL THYROIDECTOMY FOR CLINICALLY BENIGN THYROID DISEASE: A PREFERRED OPTION WITH CAPSULAR DISSECTION TECHNIQUE

Aim: This study aims to evaluate the use of total thyroidectomy as a preferred option with capsular dissection technique in diffuse bilateral benign disease, multinodular goiter and Grave s disease. The use of total thyroidectomy in treatment for benign thyroid disease remains controversial. On the other hand, the complication rate may have an increase up to 20 times in repeated operation for recurrence or incidental cancer after less than total thyroidectomy. Methods: Prospective study of 55 patients who underwent total thyroidectomy with capsular dissection technique for clinically benign disease at the National Cancer Institute, there were 46 women and 9 men with mean age 45.1 years. Indications of surgery were euthyroid bilateral midtinodular goiter, toxic multinodular goiter and Grave s disease in 46 (83.3%), 2 (3.6%) and 7(12.7%) respectively Results: The incidence of incidental thyroid cancer was 9.0% and those patients voided reoperation for completion thyroidectomy. Transient hypocalcaemia, permanent nerve injury, hematoma which needed re-operation occurred in 2 (3.6%), 1(1.8%) and 2(3.8%) patients respectively. Conclusion: Total thyroidectomy is a preferred treatment for multinodular goiter and Grave s disease when there is bilateral involvement of the gland because it decreases the likelihood of future operations for recurrent disease or incidental thyroid cancer