Outcome of Total Thyroidectomy and Subtotal Thyroidectomy in Non Toxic Multinodular Goiter: Hospital Universiti Sains Malaysia Experience

Introduction: Thyroid enlargement is one of the common surgical presentations in the Department ofSurgery, Hospital Universiti Sains Malaysia (HUSM). Among them, benign non-toxic multinodulargoiter constitutes one third (30%) of patients who underwent thyroidectomy. Common complicationsof thyroidectomy include recurrent laryngeal nerve (RLN) injury, hypocalcaemia, and recurrence ofthe thyroid lesion. Objective Methods: This is a retrospective study of patients diagnosed withmultinodular goiter treated in HUSM between January 1996 and December 2005. A total of 111 patientswere studied and 52 of them underwent subtotal thyroidectomy while 59 underwent total thyroidectomy.The outcome in terms of RLN injury, hypocalcaemia and mass recurrence were analyzed. Results: Post operative complications were studied in both groups. Permanent recurrent laryngeal nerve injury occurs in 2.4% (1 case) in subtotal thyroidectomy group compared to total thyroidectomy group (3.6%, 2 cases). Five cases from total thyroidectomy group suffered from permanent hypocalcaemia but none in the other group. 70.7% (29 cases) from subtotal thyroidectomy group have functional remnant of thyroid tissue. Recurrence rate post subtotal thyroidectomy after 5 years is only 4.9% (2 cases). Conclusion: The post operative outcome in patients who underwent subtotal thyroidectomy in HUSM from January 1996 to December 2005 was better than total thyroidectomy with significant functional thyroid remnant.