Is hemithyroidectomy a rational management for benign nodular goitre? a multicentre retrospective single group study
Cantürk, Nuh Zafer
Koçdor, Mehmet Ali
Özbaş, Serdar Mustafa
Güllüoğlu, Bahadır M.
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CitationAttaallah, W., Erel, S., Cantürk, N. Z., Erbil, Y, Görgülü, S., Kulaçoğlu, H., Koçdor, M. A., Kebudi, A., Özbaş S. M. ve Güllüoğlu, B. M. (2015). Is hemithyroidectomy a rational management for benign nodular goitre? a multicentre retrospective single group study. Netherlands Journal of Medicine. 73(1), s. 17-22.
Background: The incidence and potential risk factors for the recurrence of benign nodular goitre after unilateral thyroidectomy are not clearly defined. The aim of this study was to assess the rate of progression of nodular goiter in the contralateral thyroid lobe and of hypothyroidism requiring replacement therapy after unilateral thyroidlobectomy for benign nodular goitre.Patients and Methods: Patients who underwent hemithyroidectomy for benign nodular goitre between 2000 and 2009 were included in the study. The primary outcome of this study was the reoperation rate for recurrent goitre, the rate of progression of nodular goitre and the rate of hypothyroidism requiring L-T4 replacement therapy. Clinical factors that have an effect on progression were further analysed.Results: 259 patients were included for study. Progression of the nodular goitre in the remnant lobe was observedin 32% (n = 83) of the patients. However, over time,only 2% of these 83 patients underwent contralateral hemithyroidectomy due to this progression. Fifty-six (22%) patients required L-thyroxin replacement due topersistent hypothyroidism after hemithyroidectomy. The factors shown to affect progression of nodular goiter were advanced age, preoperative hyperthyroidism,preoperative diagnosis of toxic nodular goitre and the presence of surgical indication for a toxic goitre causing hyperthyroidism and a definitive pathological diagnosis of nodular hyperplasia.Conclusion: There was a progression of the nodular goiter in the remnant lobe in about one-third of the patients who underwent hemithyroidectomy. However, only 2% of these patients underwent complementary contralateral hemithyroidectomy due to clinical progression in 31months of follow-up. © Van Zuiden Communications B.V. All rights reserved.