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Zeki Acun, MD; Mustafa Comert, MD; Alper Cihan, MD; Suat Can Ulukent, MD; Bulent Ucan, MD; Guldeniz Karadeniz Çakmak, MD

Arch Surg. 2004;139:444-447.

Hypothesis  Near-total thyroidectomy, on the basis of its low morbidity rate, is an appropriate treatment option in the surgical management of various thyroid diseases in an endemic region in Turkey.

Design  Single-institution study of patients with various thyroid diseases treated by means of near-total thyroidectomy within 2 years in an endemic region, with comparison of the results vs the complication rates of bilateral subtotal and total thyroidectomy reported in the literature.

Setting  Tertiary academic referral center.

Patients  One hundred fifty-two patients who underwent near-total thyroidectomy for various thyroid diseases.

Main Outcome Measures  Surgical treatments of various benign thyroid diseases were compared according to the complication rates and the achievable benefits of the procedures.

Results  In our clinic, near-total thyroidectomy was the principal surgical procedure performed for benign thyroid disease. The temporary recurrent laryngeal nerve palsy rate with respect to the nerves at risk was 3.3% (10 of 304 nerves), whereas temporary hypoparathyroidism was 7.2% (11 of 152 patients). Neither permanent recurrent laryngeal nerve palsy nor permanent hypoparathyroidism occurred. In 1 patient, wound hematoma developed and required re-exploration. Seroma in another patient needed no medical or surgical intervention. Neither wound infection nor mortality were noted.

Conclusions  Near-total thyroidectomy achieves a lower complication rate of hypoparathyroidism and a similar complication rate of recurrent laryngeal nerve palsy and recurrence when compared with the rates reported in the literature for total thyroidectomy. It is an effective and safe surgical treatment option for various benign thyroid diseases.

From the General Surgery Department, School of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey.

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Arch Surg. 2004;139(4):447.
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