Total extracapsular thyroidectomy versus subtotal thyroidectomy in nonmalignant goiter

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Abstract

Introduction
There is still a debate on the management strategies for diffuse benign thyroid diseases mainly between total extracapsular and subtotal thyroidectomy in terms of efficacy and complications.
Aim
To establish the best operative management of benign thyroid diseases and to determine postoperative complications.
Patients and methods
A prospective comparative study was carried out on patients with benign thyroid disease. Two types of surgical procedures were performed: total extracapsular thyroidectomy and subtotal thyroidectomy.
Results
The study included 60 patients operated for benign thyroid disease. Controlled toxic goiter was found in 36 patients (60%), simple multinodular goiter was found in 14 patients (23.3%), primary toxic goiter was found in eight patients (13.3%), and a dominant toxic nodule was found in two patients (3.3%). Thirty patients underwent total extracapsular thyroidectomy and the other 30 patients underwent subtotal thyroidectomy. In this study, one patient (3.3%) from the total thyroidectomy group developed a complication of transient recurrent laryngeal nerve injury compared with no patients (0%) in the subtotal thyroidectomy group. Also, in this study, two patients (6.7%) in the total thyroidectomy group developed complications of hypoparathyroidism and hypocalcemia, but not in patients (0%) in the subtotal thyroidectomy group.
Conclusion
Total extracapsular thyroidectomy is a safe and highly effective procedure, with low postoperative complications.

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